Match Day

[Ray D. Ayshun]

Just got an email that it's match day. I had forgotten that still existed. Anything worth discussing?

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[elementaryschooleconomics]

Only the fact that it really doesn't matter anymore which programs have to SOAP, who, how many spots, etc.

We have several years of post-crash Match data at this point.

While multifactorial, in the end, the core concern driving the crash was the uncertain job market, with the rapid doubling of the resident/new grad pipeline being the glaring issue.

The canaries - err, Med Students - responded accordingly.

And all the programs filled all their spots anyway, either within - or outside - the Match. The core issue was not addressed.

What we're seeing is, to quote Leonard Cohen - "Everybody Knows".

Radiation Oncology is now the premiere destination for students looking for a backup option if their application is weak (or they have...felonies), foreign grads and doctors looking for a path into the USA, etc.

I fully expect the SOAP rate to be low moving forward but it IS NOT a sign of health.

 

[NotMattSpraker]

Only the fact that it really doesn't matter anymore which programs have to SOAP, who, how many spots, etc.

We have several years of post-crash Match data at this point.

While multifactorial, in the end, the core concern driving the crash was the uncertain job market, with the rapid doubling of the resident/new grad pipeline being the glaring issue.

The canaries - err, Med Students - responded accordingly.

And all the programs filled all their spots anyway, either within - or outside - the Match. The core issue was not addressed.

What we're seeing is, to quote Leonard Cohen - "Everybody Knows".

Radiation Oncology is now the premiere destination for students looking for a backup option if their application is weak (or they have...felonies), foreign grads and doctors looking for a path into the USA, etc.

I fully expect the SOAP rate to be low moving forward but it IS NOT a sign of health.

Im just very curious to see the match rate of non US MD grads. The trend is clear that US MD applicants have only slightly recovered, our "bounce back" is primarily driven by IMGs and DO grads.

These are not the typical matches PDs and Chairs are used to in this field.

Whether that is bad or good for the field, who can say? Does it even matter? We have immense talent matched into this field the last 10 years and we just have them baby sitting machines, right?

 

[Gfunk6]

I guess one thing that has been said about Match day and bears repeating is: Don't rain on the med students parade. Think back to your own Match day and how happy you were to have gotten into this field.

You will now have more colleagues to commiserate with and feel your pain.

 

[MidwestRadOnc]

That’s funny. The joy of match day.

Confession: I didn’t match into rad onc the first time around.

I don’t know what’s sadder, the pain felt on match day with no match or persevering only to end up looking at a career of linac babysitting in middle America.

 

[elementaryschooleconomics]

I guess one thing that has been said about Match day and bears repeating is: Don't rain on the med students parade. Think back to your own Match day and how happy you were to have gotten into this field.

You will now have more colleagues to commiserate with and feel your pain.

There's a reason I've avoided even mentioning this for at least a year or two.

At this point, the students know. No one coming into RadOnc will be surprised at the dumpster fire.

Might as well offer them an old, moldy banana peel and curl up under piles of newspapers and rags to watch it all burn.

 

[Mandelin Rain]

I guess one thing that has been said about Match day and bears repeating is: Don't rain on the med students parade. Think back to your own Match day and how happy you were to have gotten into this field.

You will now have more colleagues to commiserate with and feel your pain.

Yes. PLEASE! if someone expresses happiness over their match on SoMe, don't be the person to crap on them. It's immature and vile.

 

[medgator]

I guess one thing that has been said about Match day and bears repeating is: Don't rain on the med students parade. Think back to your own Match day and how happy you were to have gotten into this field.

You will now have more colleagues to commiserate with and feel your pain.

For those of who didn't have a happy match day during the boom days, it hits differently. Your point is well-taken however

 

[Ray D. Ayshun]

Yes, this wasn't a reminder to have people pile onto med student for making a stupid decision and ruining any chance they have at professional happiness. JK. Rather, just wondering how it went overall.

 

[NotMattSpraker]

I have not seen any of this at all on X this year, but not reviewing the hashtag tweets or anything. I think everyone is too busy being big mad over Jeff's letter.

Anecdote, but it seems like the IMG and DO applicants are matching at some big name programs. Nice to see. Im looking forward to the data when available.

 

[thesauce]

That’s funny. The joy of match day.

Confession: I didn’t match into rad onc the first time around.

I don’t know what’s sadder, the pain felt on match day with no match or persevering only to end up looking at a career of linac babysitting in middle America.

It is the latter

 

[drmg5000]

was a better match day for radiation oncology. Applications were up this year.

 

[RickyScott]

was a better match day for radiation oncology. Applications were up this year.

Does that mean a better match. It could also be tempered by the fact that radonc has become a safety specialty with growing realization that if your goal is solely to match in American medicined, this is the specialty.

 

[drowsy12]

From the perspective of some FMGs - the prospect of 5 years of training and expectation for a 500k employed job with decent hours is a pretty appealing gig and for the ones otherwise looking at other fields with longer roads to a higher salary, I’m sure interest will grow further.

 

[Ray D. Ayshun]

I thought I saw something like 20 unfilled programs and 26+ spots. If that's correct, I wouldn't call it better.

 

[pikachu]

I thought I saw something like 20 unfilled programs and 26+ spots. If that's correct, I wouldn't call it better.

Source?

 

[Ray D. Ayshun]

Just saw this added, suggesting 10 unfilled programs, 12 spots, perhaps post soap:

Residency Data & Reports

The latest Match results and data for the Main Residency Match.

www.nrmp.org

Otherwise, this was apparently put up re soap from nrmp showing 20+

https://www.nrmp.org/wp-content/uploads/2024/03/SOAP-101-for-Applicants-2024-Joint-NRMP-ERAS-Slides_-1.pdf

 

[Doctorer]

Just saw this added, suggesting 10 unfilled programs, 12 spots, perhaps post soap:

Residency Data & Reports

The latest Match results and data for the Main Residency Match.

www.nrmp.org

Otherwise, this was apparently put up re soap from nrmp showing 20+

https://www.nrmp.org/wp-content/uploads/2024/03/SOAP-101-for-Applicants-2024-Joint-NRMP-ERAS-Slides_-1.pdf

Did not all decide to soap?

 

[thecarbonionangle]

was a better match day for radiation oncology. Applications were up this year.

Great spin! The field has never been better! The usual hellpits interviewed everyone with a pulse and even then some of them were pathetic enough to still end up on SOAP scraping bottom of pot. SAD

 

[communitydoc13]

I don't care about match specifics, but do suspect that any marginal positive change in application numbers will be viewed by academic leadership as a rationale for existing residency numbers. Numbers look roughly the same as last year to me,,, and you would have to be an insider to have a sense of relative quality.

The field is no longer competitive. That is fine. A nearly infinite source of IMGs out there to fills spots.

It was our mistake to conflate competitiveness with value.

DO grads now 50% as numerous as MDs (nationally, not in radonc). This has been gradual, but marks a big change in proportionality relative to 20 years ago.

Sheer level of dependency of our system on IMGs is remarkable. (This has been the case forever).

 

[fiji128]

Plenty of data out there already that shows that match or no match / soap or no soap, approved residency positions do not go unfilled. Will try and run this year’s acgme data again in the near future

 

[bubbachuck]

sometimes I wonder if we're living in the same universe.

personally, for each of the past 3 years, there's been plenty of jobs and folks have been happy. The residents who are good get better jobs. I don't know a single resident coming out of training who is miserable "babysitting a linac in the middle of nowhere" so to speak.

it may be be true that salaries aren't as lucrative as they were in the past (that's what SDN tells me), but at least where I'm at, rad onc is respected as a partner in oncology, the salaries are competitive for the work, and our opinions are sought after. happiness and compensation are from what I hear loosely correlated anyway (otherwise neurosurgeries would be the happiest doctors).

It wasn't long ago that I was also in a "our field is dying" phase but my opinion has slowly been changed by continuous evidence at multiple programs (more and less prestigious) that folks are happy. the people who aren't happy seem to be people who are difficult to work with.

this only reflects my experience however so YMMV

 

[elementaryschooleconomics]

sometimes I wonder if we're living in the same universe.

personally, for each of the past 3 years, there's been plenty of jobs and folks have been happy. The residents who are good get better jobs. I don't know a single resident coming out of training who is miserable "babysitting a linac in the middle of nowhere" so to speak.

it may be be true that salaries aren't as lucrative as they were in the past (that's what SDN tells me), but at least where I'm at, rad onc is respected as a partner in oncology, the salaries are competitive for the work, and our opinions are sought after. happiness and compensation are from what I hear loosely correlated anyway (otherwise neurosurgeries would be the happiest doctors).

It wasn't long ago that I was also in a "our field is dying" phase but my opinion has slowly been changed by continuous evidence at multiple programs (more and less prestigious) that folks are happy. the people who aren't happy seem to be people who are difficult to work with.

this only reflects my experience however so YMMV

I live in this universe as well!

You and I are observing similar things re: the current job market.

The question is why are we seeing this? What changed?

That's "easy": it's a combination of the "Silver Tsunami" and the pandemic.

The healthcare system as a whole ain't doing so hot. The pandemic and well, uh, a whole lot of things is creating a very...stressed out population.

This caused a lot of Boomer-age doctors (not just RadOnc) to dial back their clinical presence or retire completely.

But...those same Boomer-age retirees are more likely to get cancer and become patients themselves.

So, the same or increased number of patients with fewer docs to treat them.

I'm still very negative on the outlook of the RadOnc market in the long term because this is a temporary situation. We're pumping out 200 new grads each and every year. Hypofrac and omission guidelines are unlikely to go anywhere. The pharma lobby will always be significantly stronger than radiation, so when pieces of the pie are shuffled, it's unlikely our portion is going to increase...or even stay the same.

But the increased rate in RadOnc's retiring or decreasing their clinical load isn't "permanent" the same way the 200 new grads per year situation is.

I don't know when the math on this equation changes. I don't think it's next year, but at this point I don't like making predictions more than 6 months out. I don't know what the next Black Swan event is for us, either. Hopefully it's something like "IMRT 2.0", but it could also be "ultra-effective chemo pill that reduces the need for radiation by 50%".

So I maintain my "all things being equal" outlook, and right now, if nothing changes, the new grad pipeline is set to remain at "fire hose" level. But the Boomer exits have a ceiling.

 

[RickyScott]

sometimes I wonder if we're living in the same universe.

personally, for each of the past 3 years, there's been plenty of jobs and folks have been happy. The residents who are good get better jobs. I don't know a single resident coming out of training who is miserable "babysitting a linac in the middle of nowhere" so to speak.

it may be be true that salaries aren't as lucrative as they were in the past (that's what SDN tells me), but at least where I'm at, rad onc is respected as a partner in oncology, the salaries are competitive for the work, and our opinions are sought after. happiness and compensation are from what I hear loosely correlated anyway (otherwise neurosurgeries would be the happiest doctors).

It wasn't long ago that I was also in a "our field is dying" phase but my opinion has slowly been changed by continuous evidence at multiple programs (more and less prestigious) that folks are happy. the people who aren't happy seem to be people who are difficult to work with.

this only reflects my experience however so YMMV

No jobs are available in my city. In fact there are a number of desirable Metros in which there are not jobs available . Compared to other fields we are worse off.

 

[elementaryschooleconomics]

From the prolific Sheriff of Sodium, it appears we still rank in the top 5 of unfilled spots by percentage.

We're still competitive, just playing a different game! CAN'T TAKE OUR CROWN!

 

[RickyScott]

list of programs that did not fill?

 

[drowsy12]

list of programs that did not fill?

per the google doc, these were the programs that had spots open as of SOAP day last monday:

University of Texas Medical Branch

University of Kentucky

University of Arkansas

University of Alabama

Sidney Kimmel Medical College at Thomas Jefferson

Kaiser Permanente Southern California

Detroit Medical Center/Wayne State

Dartmouth-Hitchcock

 

[Lamount]

Anecdotally, a fair number of the FMGs I have seen these past several application cycles are foreign born and are planning on practicing abroad. If this is a truly the case, they may have less of an impact on the job market.

 

[OTN]

Anecdotally, a fair number of the FMGs I have seen these past several application cycles are foreign born and are planning on practicing abroad. If this is a truly the case, they may have less of an impact on the job market.

In that case it's a waste of taxpayer resources for them to be trained and the spots should be cut.

 

[medgator]

In that case it's a waste of taxpayer resources for them to be trained and the spots should be cut.

100%. Need more psych, critical care docs even urologists.

 

[communitydoc13]

100%. Need more psych, critical care docs even urologists.

Huge point.

Every radonc out away from major metros knows how scarce other specialists and even PCPs are. (Medonc, ENT, Surgonc...even GI is understaffed in the setting our present demographic shift....literally 7 months to consult near where I live).

I honestly believe that we are in the best staffed specialty in all of medicine. Literally every other field needs more docs than we do (with the possible exception of path?).

The shortage of docs in other specialties is compromising the viability of many smaller hospitals. Not radiation oncology.

 

[yesmaster]

sometimes I wonder if we're living in the same universe.

personally, for each of the past 3 years, there's been plenty of jobs and folks have been happy. The residents who are good get better jobs. I don't know a single resident coming out of training who is miserable "babysitting a linac in the middle of nowhere" so to speak.

Fair perspective.

However unless you have numbers and location, it’s all a wash. I’m sure for an optimistic glass half full person, depending on your peers in college and med school and how they’re doing, depending on your residency program, depending on your spouse/SO and whether they’re SAHM SAHD versus having their own career and geography preferences, and if your roots are in the Midwest then rad onc may have been okay last few years. Of course if you’re academic at certain centers then everything is always good all the time.

Established faculty at big, name brand academic centers are probably doing pretty well, they live in a totally different world versus rad oncs in the community. My impression versus 15-20 years ago is that faculty used to have to publish, run trials, get grants to be relevant, now there’s other leadership opportunities associated with managing a large clinical enterprise, so that makes the job easier and more secure.

 

[medgator]

Huge point.

Every radonc out away from major metros knows how scarce other specialists and even PCPs are. (Medonc, ENT, Surgonc...even GI is understaffed in the setting our present demographic shift....literally 7 months to consult near where I live).

I honestly believe that we are in the best staffed specialty in all of medicine. Literally every other field needs more docs than we do (with the possible exception of path?).

The shortage of docs in other specialties is compromising the viability of many smaller hospitals. Not radiation oncology.

And this is where ASTROs position is blatantly wrong, hurts everyone that isn't at the top and wastes societal resources training docs we don't need in the system with training dollars better spent elsewhere

 

[Reaganite]

That family medicine bar WOW.

 

[radoncftw]

Fair perspective.

However unless you have numbers and location, it’s all a wash. I’m sure for an optimistic glass half full person, depending on your peers in college and med school and how they’re doing, depending on your residency program, depending on your spouse/SO and whether they’re SAHM SAHD versus having their own career and geography preferences, and if your roots are in the Midwest then rad onc may have been okay last few years. Of course if you’re academic at certain centers then everything is always good all the time.

Established faculty at big, name brand academic centers are probably doing pretty well, they live in a totally different world versus rad oncs in the community. My impression versus 15-20 years ago is that faculty used to have to publish, run trials, get grants to be relevant, now there’s other leadership opportunities associated with managing a large clinical enterprise, so that makes the job easier and more secure.

the whole paradigm has changed.
look up salaries for docs at public institutions (i.e. MDACC).
No doubt that many docs mid career are making more than partners in PP or hospital-employed docs.

 

[radiation]

From the prolific Sheriff of Sodium, it appears we still rank in the top 5 of unfilled spots by percentage.

We're still competitive, just playing a different game! CAN'T TAKE OUR CROWN!

View attachment 384180

link to the full post

Match Day 2024: Winners & Losers Edition

The rank order lists were submitted. The button was pressed. And earlier today, 35,984 Match participants learned their fates. And you know what that means. Yup, that’s right. It’s time to break it…

thesheriffofsodium.com

and dont forget this part

 

[Neuronix]

Interesting blog. From his post in 2021:

Go back to 2011, [... and] the 85% match rate for U.S. seniors in radiation oncology was lower than the rate for neurosurgery or otolaryngology, and radiation oncology applicants had the same mean Step 1 score as those entering orthopedics.

 

[MidwestRadOnc]

Interesting blog. From his post in 2021:

Go back to 2011, [... and] the 85% match rate for U.S. seniors in radiation oncology was lower than the rate for neurosurgery or otolaryngology, and radiation oncology applicants had the same mean Step 1 score as those entering orthopedics.

Imagine having the creds to get into neuro or ortho in 2024 and choosing rad onc instead. I mean, yeah residency will be a cakewalk, but yikes.