FAST FACTS:
Number of first year residency positions offered in the NRMP in 2011: 16
Filled with US grads in 2011: 93.8%
Number of second year residency positions offered in the NRMP in 2011: 155
Filled with US grads in 2011: 96.8%
Length of training: 5 years, including a PGY-1 year
Number of residency programs: 83
Number of residents in training: 608
Competitiveness: Very High
Selection criteria for interview/ranking: grade in elective in the specialty, number of honors grades, published medical school research, grades in required clerkships, a strong background in physics
US senior matched applicants' mean Step 1 score: 238
US senior matched applicants' mean Step 2 score: 241
Number in US Board Certified in specialty: 3,414
Median compensation for all physicians in specialty: $375,000
Average work hours per week: 56
EVEN THOUGH THE AMERICAN BOARD OF RADIOLOGY RECOGNIZED therapeutic radiology (now called radiation oncology) as a distinct field as early as 1934, initially it was practiced mostly by surgeons or as "a sideline to radiodiagnosis."1 The radiation oncologist treats the patient with x-rays, radium, and radionuclides. As a clinical practice, the "art of working with cancer patients" is as important as "the physical and biologic underpinnings of this interesting field."2
Residency Information. Applicants need to complete a transitional or preliminary internship year before starting their radiation oncology training. Competitive applicants also have a strong background in physics and research interest. The residency curriculum includes rotations through oncology subspecialties to provide a broad understanding of oncology.
Board Certification. The American Board of Radiology awards board certification in radiation oncology. You need to pass both written and oral examinations.
Supply and Projections. An American College of Radiology survey3 of 600 radiology groups revealed that there was a serious shortage of employment opportunities as recent as eight years ago; but, the situation is rapidly changing. Demand for radiation therapy is expected to grow 10 times faster than supply between 2010 and 2020.4
Economic Status and Types of Practice. Radiation oncologists earn above the average income of US physicians. As hospital-based specialists, radiation oncologists have relatively low practice expenses because the hospital provides personnel, facilities, equipment, and supplies. In addition, this specialty employs non-physicians to perform many services, thereby yielding a higher volume of patient care. Finally, reimbursement for services is often made by third-party payers who provide greater coverage for hospital services than for those offered in the office.
Further Information. The American Society for Radiology Oncology, 8280 Willow Oaks Corporate Drive, Suite 500, Fairfax, VA 22031. Telephone (703)502-1550. Internet address: www.astro.org.
Medical schools do not offer radiation oncology as a required part of the curriculum, and therefore it is often chosen on the basis of less actual experience than some of the other specialties. Respondents report that they were attracted to radiation oncology by the "reasonably regular hours" and the new technologies. Some found the intense patient relationship that may last beyond the expected four to six weeks of treatment to be an initial attraction.
"The feeling that I can intervene and perhaps cure someone is very satisfying." All respondents enjoy procedures requiring manual dexterity, skill, and experience. Also liked are the interactions with clinical physicians, time off, and the consultant role.
"It is difficult to form relationships with patients and then see them die.'' This theme is similar to the views expressed by medical oncologists.
Radiation oncologists work in hospital settings and have a predictable patient care schedule. In academic centers, more time is spent on research and teaching than in community hospitals. There is little night call.
Communication skills are needed to effectively deal with seriously ill cancer patients and their family members. In addition, radiation oncologists work with radiation technologists and must be able to work on a team.
Radiation oncologists describe themselves as "compassionate." Myers-Briggs Type Indicator studies5 indicate that radiation oncology seems to attract those who enjoy patient care.
"Learn as much as possible about anatomy, surgical oncology, and chemotherapy during medical school and internship." An interest in research is valued at larger residency programs. Also, a strong background in physics is "helpful."
All respondents cite the task of keeping up with radiobiologic concepts. There also are pressures to give greater consideration to patients' quality-of-life despite the difficulty of measuring this subjective variable.6
You can complete the questionnaires and obtain your scores for all specialties online at http://www.sdn.net/schools/selector .
del Regato JA, Brady LW. Therapeutic radiology. JAMA 1981;245:2222.
Gunn W. Book review: Principles and practice of radiation oncology. JAMA 1998; 279(17):1406.
Smith BD, Haffty BG, Wilson, LD et al. The future of radiation oncology in the United States from 2010 to 2020: will supply keep pace with demand? J Clin Oncol 2010 Dec 10; 28(35):5160-5165.
Smith BD, Haffty BG, Wilson, LD et al. The future of radiation oncology in the United States from 2010 to 2020: will supply keep pace with demand? J Clin Oncol 2010 Dec 10; 28(35):5160-5165.
Bushee GR, Sunshine JH, Chan WC, Shaffer KA. The demand side of the job market for diagnostic radiologists and radiation oncologists: Hiring by physician groups in 1995. Am J Roentgenol 1996;167(2):303-309.
Gunn W. Book review: Principles and practice of radiation oncology. JAMA 1998; 279(17):1406.