Guest MD2006 Posted June 10, 2004 Report Share Posted June 10, 2004 I am wondering if anyone out there has any info about radiation oncology. From what I have seen, the pros are working with a great set of patients, being able to make a difference in patients' clinical course and integrating radiology with a clinical practice. How about lifestyle? I know that financial compensation is great, but how much call, hours per week, etc would you typically have as a rad onc, any insight? Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted June 10, 2004 Report Share Posted June 10, 2004 I think lifestyle has always been considered one of the perks of radiation oncology. Even for the true oncological emergencies treated with radiation (SVCO, Spinal Cord Compression, etc) the radiation oncologist's role can usually wait until morning. This was a pretty popular specialty choice for the class of 2004 at UWO. Link to comment Share on other sites More sharing options...
Guest Sarah371 Posted June 11, 2004 Report Share Posted June 11, 2004 I am biased but Rad Onc is a great specialty....you combine an on going relationship with your patients and their families with a surgical way of thinking (treatment volumes)...plus there is an increasing amount of procedures that you can do with brachytherapy etc. It is a lifestyle choice specialty with clinics running Monday To Friday in Canada.....very few emergencies and in some places home call even for the residents. Training requires a pretty standard rotation year with gen surg, gyne onc, radiology, internal med, pediatrics and emerg. Eight more months of internal medicine are required with 3 of them being in general internal and 3 in medical oncology. The second half of PGY-2 to PGY-5 are all rad onc rotations. Therefore I am expecting my first year and a half of residency to be pretty yucky in terms of hours. After that it gets much better. It is considered an academic field because the majority of clinics/training programs are attached to universities ( no one in Canada owns there own radiation machines) but there is and increasing number of satellite clinics and I am not sure what there research criteria are. About eight years ago the college said that there were to many radiation oncologists and that they were not going to hire anymore.....as a result a lot of residents left the field entirely or went to that States for jobs...therefore it became very unpopular for a while. It has however become much more popular in the last few years with 44 applicants for 21 positions and 27 people ranking it first. Any other questions please ask. SARAH Link to comment Share on other sites More sharing options...
Guest MD2006 Posted June 11, 2004 Report Share Posted June 11, 2004 Sarah, so I take it that you are doing your residency in rad onc, so maybe I can ask you some questions about the selection process. What do you think are the key aspects to have in your application? How do the training programs compare across canada? What were the key things that made you choose it? Were there other specialities that you were considering too? I'm doing a summer project in rad onc and am really liking it, but I also really like med onc and allergy/immunology as well, so many choices! I also had some questions about brachytherapy, do the rad onc give the brachy, or do the surgeons? At rounds the other day they were discussing a single mass in the right main bronchus and considering rads vs brachy and the thoracic surgeon seemed to be the one who would give it, does it vary depending on the complexity of the sight ie. prostate vs bronchus? Another question, how many sites does each rad onc treat and how/when do you decide which you are going to treat (ie. heme, GI, ENT, breast, lung etc.) What about peds? Do you need special training for peds rad onc? Finally, how much of a background in physics do you need? I have never taken a physicis course, EVER, not even in high school (goodness only knows how I made it through the physical sciences part of the MCAT). Thanks! Link to comment Share on other sites More sharing options...
Guest Sarah371 Posted June 13, 2004 Report Share Posted June 13, 2004 Hey MD2006, I try to give your questions and answer but I am by no means and expert in the field 1) Key aspects to the application....I think that having some research under your belt is important....I think UofT would not interview you if you did not have some evidence of research productivity the other schools I don't know. It is also important to show that you at least have and idea of what the field is about....you want to do at least couple of electives at your top choices and probably and elective in medical and one in surgical oncology. 2) The top three programs in Canada are UofT, BC and University of Alberta (by reputation and you could successfully argue that others could be in the top three)....they all have really good communication between research and clinical. No program is big....maximum of 4 residents per year but you have to choose a program based on what you want and the type of environment that you feel that you will work best in, also think about your fellowship, if you are at all planning on and international one you are better off at a internationally known program (it will make your life easier but that is not to say that you won't get and international fellowship from a smaller program). UofT is probably the best known internationally, Alberta has every toy you could want and Vancouver is a strong academic program. Some of the smaller programs a good a s well....Kingston is really up and coming....they have been rebuilding for the past 3 years and have a program director who is really committed. McGill has no in house call and has a really strong medical physics department. Ottawa is a really good all around program. The residents in all the programs that I applied to are really happy and all loved their programs....so you really have to go with your gut on this one. 3) The only other specialty I applied to was urology....I thought for sure that I would back up with internal but I fell in love with surgery and thought that with urology I could sub-specialize in urological oncology. 4) For bronchial brachytherapy it is a real team approach.....the RO does the planning of treatment volumes and often a thoracic surgeon does the procedure...sometimes a respirologist is involved. For Prostate it is the RO who inserts the seeds. Why this is I don't know but I am sure that if you were interested you could do the procedure as and RO.....my mentor says that most ROs don't feel comfortable doing procedures so they let the surgeons do it but that there are a lot of procedures that you can do as an RO. 5) You train in all sites doing 2-3 month rotations in each....but when you practice you often choose and area that you are interested in a "boutique" out in that. At some centres you are required to do two sites a work horse site like lung or colon and then maybe an area that you are interested in.....the great thing about being an RO is that if you do breast for 5 years and decide you are sick of it you can switch to CNS or lymphoma if there is a space available in your centre. However if you do a fellowship in a certain area like prostate then you are most likely going to want to continue to do that site since it is a area you are interested in. 6) There are very few situations in which children are given radiation...I have never heard of anyone specializing in it...I assume you would work very closely with the pediatric oncologists. 7) They will teach you the physics you need...in Ontario they run a course in year one...I only have 1st year university physics and it was non-calculus based. You will have medical physicists that will go over each of your treatment plans. It is probably more important to have a good handle on Anatomy and be able to think spatially than to be physics wiz. I hope this helped. SARAH Link to comment Share on other sites More sharing options...
Guest MD2006 Posted June 14, 2004 Report Share Posted June 14, 2004 Great Sarah, thanks for taking the time to answer. If I have any more questions along the way, I'll be in touch! Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted June 19, 2004 Report Share Posted June 19, 2004 Just as an aside, Radiation Oncology is a pretty competitive field in Canada (particularly this year), but it is ultra-competitive in the US. This niche specialty is in the same level of competitiveness in the US as Derm and Plastics, and more competitive than other fields like Ophtho, ENT, Ortho, Urology, etc. It's definitely a lifestyle-friendly specialty, lots of technological advances, lots of reading and academic work to keep up with the latest trials and papers, and a lot of future growth. Ian Link to comment Share on other sites More sharing options...
Guest MD2006 Posted June 21, 2004 Report Share Posted June 21, 2004 Hey Ian, thanks for the input. I have been talking to some residents about it lately and they have also said how competitive it has become over the last little while. They do have really neat toys, lots of cool imaging! Link to comment Share on other sites More sharing options...
Guest MD2006 Posted July 27, 2004 Report Share Posted July 27, 2004 More questions about RadOnc.... What is the job situation going to be like in the next ten years? Is there a concern that there will be too many Rad Oncs and not enough jobs or will there always be a need? Sarah: What 4th year electives did you do? How important is it to do a rotation at the centres where you are applying? Since I will have four elective blocks in 4th year, should they all be in radonc or should I do others as well? Which centres are more clinical than academic? Are radoncs payed by salary or fee-for-service? Thanks! Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted July 28, 2004 Report Share Posted July 28, 2004 I'm not Sarah, but I think the future of Radiation Oncology is extremely bright. They're always coming out with new trials and new technology for nuking tumours, and RadOnc fits very nicely within the framework of minimally invasive treatments that don't require lengthy inpatient stays. With demographics the way they are at present (increase in the elderly population, increase in elderly physicians retiring, and RadOnc being a very highly evolving field that is unlikely to be usurped by midlevel providers), the future looks very bright indeed. Just my opinion. Ian Link to comment Share on other sites More sharing options...
Guest MD2006 Posted July 28, 2004 Report Share Posted July 28, 2004 Awesome, thanks Ian Link to comment Share on other sites More sharing options...
Guest Sarah371 Posted July 29, 2004 Report Share Posted July 29, 2004 I agree with Ian in that I think that the job situation is good for the next little while.....I don't know about other provinces but Ontario is opening up a lot of satellite centers in places like Oshawa and Kitchener/Waterloo. About seven years ago Canada claimed that they had a shortage of job spaces and lost a lot of people to the states and to other specialities....because of that people stopped applying to the programs. I don't think that that will happen again. Another plus of the speciality is that Canadian trained Rad Oncs can pretty much go anywhere in the world with their training and be very well thought of. I did two electives in rad onc and two in med onc (at Toronto and BC) both were my top choice schools. I wanted to do an elective in surgical oncology but was unable to secure a spot at either of those two schools. I think that doing an elective at the school you want to get into can only help...then the people know you and what you are capable of. All centres are academic to some extent as all the centers are attached to a university. Some of the smaller programs put less of an emphasis on research like Queen's, McGill (I got more questions about my willingness to teach there than about my research), Calgary, and Western. Rad Onc's are on salary and paid off a grid you move up one axis for years in and the other axis for extras like graduate degrees, research, teaching etc. SARAH Link to comment Share on other sites More sharing options...
Guest MD2006 Posted July 29, 2004 Report Share Posted July 29, 2004 Thanks again Sarah. I have seen radonc salaries for the US, are canadian salaries comparable? What can a rad onc just finished residency expect to make? Link to comment Share on other sites More sharing options...
Guest Sarah371 Posted July 31, 2004 Report Share Posted July 31, 2004 Salaries here are less than in the US but most likely insurance is lower (but don't quote me on that one). First year out most Rad Oncs make 120 -150 K depending on research experience etc. Also remeber that you don't have to pay for over head, nursing or administrative costs so that is take home. Link to comment Share on other sites More sharing options...
Guest walton1 Posted August 8, 2004 Report Share Posted August 8, 2004 Hello all, Rad oncs in NS are all on salary. Here are some interesting links. (Make sure you read both!) http://www.cmaj.ca/cgi/content/full/165/7/886 http://www.cmaj.ca/cgi/reprint/156/12/1739 wally Link to comment Share on other sites More sharing options...
Guest Sarah371 Posted August 10, 2004 Report Share Posted August 10, 2004 Wally, Those are really interesting articles....a number of people I know went to the US to work...some did masters and PhDs to make themselves more marketable. It does seem that things have turned around but who knows....positions increased across Canada this year but main in BC with two new positions being funded. I think that more jobs will come available as satellite clinic get up and running...in Ontario at least two new centers have opened in Oshawa and Kitchener/Waterloo. But then there are some people who want to do academic medicine and have no interest in community practice....that was one of the draws for me...that I would always be involved in an academic center. Will history repeat itself....only time will tell. SARAH Link to comment Share on other sites More sharing options...
Guest walton1 Posted August 15, 2005 Report Share Posted August 15, 2005 Whoops, Added a question that was already answered... sorry folks. wally Link to comment Share on other sites More sharing options...
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