Cancer Care specialty
Radiation Oncology: Salary, Residency & Career Guide
Cancer treatment with precisely planned radiation delivered over longitudinal courses.
Typical Training
4+1 years
Clinical year plus four years of radiation oncology.
Attending Compensation
$613,837
Average Total Compensation
Employment outlook
Not isolated
Projected Job Growth
Relative Competitiveness Index
36 / 100
Lower
Start in Medical School
M1 to M4 Preparation
Practical experience, projects and rotation planning.
See the Medical School RoadmapAttending Compensation and State Wages
U.S. Attending Compensation
$613,837
Average Total Compensation
BLS does not publish a separately matched state wage series for this specialty.
Resident Pay by Institution
Clinical year plus four years of radiation oncology..
2026–27 salaries, five published training-institution examples.
Selected institution
University of Michigan, Ann Arbor, MI
$77,049/ year
Pay varies by institution and postgraduate year.
Schedules and Work Setting
Schedule and Call
Consultation, treatment planning, contouring and weekly on-treatment visits are scheduled in blocks. Urgent palliative radiation or complex inpatient consults can interrupt the planned day.
Practice Settings
Cancer centers, radiation departments and multidisciplinary oncology clinics.
Procedures and Clinical Work
- Radiation treatment planning
- Image-guided radiotherapy
- Brachytherapy in selected settings
- Multidisciplinary oncology decisions
Fellowship Training
Fellowship Expectation Index
1 / 5
Fellowship Options
Common Fellowship Duration: 1 year(s) beyond residency. Brachytherapy or pediatric radiation oncology fellowships are optional.
Radiation oncology residency includes extensive oncologic and physics training; fellowship is usually selective.
Direct Practice
General radiation oncology in community and academic treatment centers.
Specialized Practice
Brachytherapy and pediatric radiation specialization may favor advanced exposure or fellowship.
Choosing a Path
Choose a program with the brachytherapy and disease-site volume you need before assuming extra training is necessary.
Potential Fellowship Pathways
- Brachytherapy
- Proton therapy
- Pediatric radiation oncology
Preparing in M1 Through M4
Follow a cancer patient from tumor board through simulation, planning, radiation fractions and follow-up. Physics and longitudinal oncology decisions are central.
Research or QI
A radiation-plan quality study, toxicity outcomes registry, adaptive RT project or dose-constraint audit provides substantive exposure.
Common Mistake
Choosing radiation oncology because you like imaging while overlooking oncology conversations, toxicities and treatment planning.
Preparation by Year
- 1Observe an initial consultation, CT simulation and weekly on-treatment visit for the same disease site.
- 2Ask medical physicists how treatment planning, safety checks and physician approval intersect.
Ask a resident this: How many disease sites does a senior resident independently plan under supervision, and what is the brachytherapy volume?
MD vs DO Match Outcomes
119 of 122 matched to their preferred specialty
U.S. DO Seniors: No comparable 2024 preferred-specialty cohort reported.
Applicant Considerations
Radiation oncology was absent from the 2024 DO preferred-specialty summary table, so a valid DO versus MD percentage cannot be displayed.
DO Application Strategy
Work with a radiation oncology mentor on clinical fit and detailed program research instead of relying on broad application statistics.
Job Outlook
N/A
Projected Employment Growth
2025 to 2035, BLS occupational projection
No distinct employment forecast is published for this exact specialty.
AI and the Specialty
Potential Workflow Changes
Automatic contouring and dose planning are active AI use cases; medical oversight and patient counseling remain central.
Sources & Data Notes
Reviewed . National attending compensation uses Doximity's 2026 specialty survey (2025 pay) where available, then verified specialty-specific Medscape, Marit or Salary.com estimates. Doximity, Medscape and Marit report total compensation; Salary.com models base salary. Survey averages, modeled salaries and BLS wage medians measure different populations and must not be interpreted as identical metrics. BLS May 2025 state wages are shown separately and exclude self-employed physicians. The ophthalmology BLS category excludes pediatric ophthalmologists. State figures may be missing, top-coded, or suppressed. Job outlook uses BLS 2025–2035 occupational projections; it is not a local vacancy forecast. Resident stipend examples reflect published institutional scales for 2026 to 2027, by postgraduate year, not specialty. Stanford includes housing in its reported base salary; other institutions handle allowances differently.
The Relative Competitiveness Index uses a fixed score of 25 plus 1.75 times the 2024 U.S. MD preferred-specialty unmatched percentage, rounded, then applies the same 1.225 multiplier to every specialty. Neurological Surgery is 98/100; the score is not the applicant's chance of matching. It is not a 2026 estimate or DO-specific score. The MD and DO percentages compare different unadjusted applicant cohorts who ranked that specialty first. They do not account for application strategy, program selection, scores, or geography. Ophthalmology and urology have separate specialty match processes; other pathways may lack suitable NRMP cohorts.
The 1–5 Fellowship Expectation Index is an editorial assessment of customary career paths, not a measured participation rate or requirement. For residency profiles, compact training labels put specialty years before the clinical base or preliminary year; e.g. 3+1 means three specialty years and one clinical base year, even though the clinical year comes first. Fellowship-defined careers are presented in the separate fellowship explorer. Schedules, procedural scope, preparation suggestions, and potential AI effects depend on the program and practice setting; they are qualitative descriptions, not guaranteed outcomes or forecasts of physician replacement.
For Radiation Oncology: Doximity 2026, Average Total Compensation, reported under “Radiation Oncology.” The national estimate must not be treated as a state-specific compensation figure.
Radiation Oncology: Editorial estimate of how fellowship shapes a career path. No observed fellowship uptake percentage is implied. Specialty-specific roadmaps describe illustrative activities, not mandatory publication, shadowing-hour, rotation, or skill requirements. Common fellowship routes: Brachytherapy or pediatric radiation oncology fellowships are optional.