In some cases Rad oncs are being entirely excluded from treatment of certain cancers. Can someone explain why hypofractionation say from 40 to 5 fractions doesn't cause Rad Onc's income to drop from $400k to at least $200k? Not sure how the math works but a drop is surely in order. Condensing 30-40 treatments down to 5 should commensurately decrease pay precipitously. But from hypofractionation, especially for prostate cancer and breast cancer. Decreased need for radiation in the general population. Yes to some extent this does exist in many specialties, but it is undoubtedly the worst in Rad Onc, I don't think anyone could argue with that (except maybe regarding pathology). If we keep graduating 200 Rad Oncs per year, then when I come out of residency in 2028, the job market will be extremely saturated with 15 years of 200 resident class sizes. ASTRO and other organizations not willing to decrease residency spots due to ulterior motives of academic residency programs using free labor and saying it would be "anti-trust". As a result of supply and demand mismatch, many benefits of the job have decreased. Many if not most residents not able to find a job where they want. Job market in utter state of collapse given residency expansion from 100 residents per class 10 years ago to 200 residents per class now. However, there seems to be a sense of doom and gloom about the future of the specialty for the following 3 reasons, which I've gathered both from speaking to residents face to face: Also has a pretty good lifestyle with pretty much 8-5 hours. I've liked it more than any other rotation so far in terms of the day-to-day work. Enjoyed the field, including the time that is spent with patients on something very meaningful, treating cancer, most treatments curative, artsy aspect of the treatment design, and many other things about the day to day job.
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