Radiation oncology resident salaries: A comparative analysis of resident compensation with cost of living adjustments

Summary: Compensation is a rarely discussed but important factor when considering various training programs. While most institutions post their salaries online, a comprehensive comparison adjusting compensation for cost-of-living (COL) would be tedious for an individual applicant to undertake. We utilized radiation oncology as a test-case, to assess the national landscape of resident compensation accounting for COL, which can significantly modify the purchasing-power of a resident’s salary. We identified 87 radiation oncology residency programs from Accreditation Council for Graduate Medical Education database. We performed a simple internet search for resident salaries hosted on official websites of the sponsoring institutions to compile a table of salaries by post-graduate year (PGY). Only institutional data that clearly indicated values for the 2024-2025 academic year were included to avoid the use of outdated information. We used COL indices (COLI) for the city listed in each program’s main address to make COL-adjustments. Eighty-four of the 87 identified radiation oncology programs were evaluable. Table 1 shows summary statistics of COLI and base salary by PGY level with and without COL-adjustment. Table 2 shows the relative effect on quartile ranking after COL-adjustment. Approximately 12 programs fell from top quartile to bottom quartile, while approximately half of programs rose to a higher quartile after COL-adjustment. Base salaries vary widely. COL-adjustments can have a large effect on the relative purchasing-power that a resident would have in their respective geographic area. A key limitation of this analysis is that it does not account for additional non-salary compensation such as health benefits, moonlighting opportunities, retirement contributions, and various stipends. Additionally, COLI is derived from costs of goods and services, but it does not factor in differences in state income tax. This analysis underscores the importance of comprehensive evaluations incorporating both base salary and COL adjustments to assist prospective residents considering financial differences between residency training programs. Vincent Cassidy (he/him/his), n/a (Presenting Author) - University of Florida; Ryan Brisson (he/him/his), n/a (Co-Author) - University of Florida