Chirag/Royce Editorial, Goodman Article, Potters Response on Job Market 031121

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SubserviantToABR said:
Here's another article from today from Paul Harari and crew: https://www.redjournal.org/article/S0360-3016(21)00216-9/abstract

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This misses the point completely. We need more "exposure?" Really? There were plenty of med students interested in the specialty just a few short years ago, and I remember hearing that med students weren't getting enough exposure to radiation oncology then, when we were swimming in applicants.
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SubserviantToABR said:
Here's another article from today from Paul Harari and crew: https://www.redjournal.org/article/S0360-3016(21)00216-9/abstract

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Someone should ask the first author of this study about the rumor that his group was looking to replace a retiring partner this year and then decided not to hire after APM dropped.

All rumors, of course, but one I've heard floating around. I'm not entirely sure how you can defend the job market while simultaneously watching/participating in one of the main concerns of the RadOnc market (retiring people not being replaced because of fears over decreased reimbursement).
 
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One thing I wasn't totally aware of: when U.S. seniors *are* applying to rad onc, we are still getting superstar applicants the likes of which we got back in peak rad onc.

What does this mean??? Lots of crazy potential ramifications. Rad onc attracts the highest number of gaslightable geniuses in medicine? There's a coterie of very effective (maybe even good doctors too) honest recruiters to rad onc and they think they're still doing God's work? There's a sad contingent of people who still make reservations to a restaurant which lost its Michelin star a long time ago and just don't keep up with reviews?

 
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SubserviantToABR said:
Here's another article from today from Paul Harari and crew: https://www.redjournal.org/article/S0360-3016(21)00216-9/abstract
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"An additional concern identified by both studies involved perceptions surrounding the job market. In an analysis of the 2016-2017 job market, Chowdhary and colleagues found a modest mismatch in the number of job opportunities compared with the number of residents trained in specific geographic regions of the US, particularly in the Northeast9 . Nevertheless, in a separate study Chowdhary and colleagues identified that 75% of residents received job offers in their preferred region10. Valuable additional data are now emerging, such as the ARRO 2020 graduating resident survey reported at ASTRO 2020 which found that 177/179 (98.9%) of graduating residents received job offers prior to graduation, with 89% reporting they were satisfied or very satisfied with their accepted position11. This 2020 resident survey further reported that 73% of graduates were offered first year salaries >$300,000, ranking radiation oncology among the highest paid of the 20 specialties surveyed11. With high satisfaction reported by the majority of graduating radiation oncology residents, job market concerns may in part reflect anxieties perpetuated by a vocal minority on social media. It is valuable for our specialty to recognize the powerful influence of social media, particularly within a small field where a few voices (often posted anonymously) can magnify impressions and concerns for medical students. Real job market data regarding annual job placements will continue to provide a valuable ground truth for students and residents in the field of radiation oncology."

You guys are just posting too much. Plenty of folks finding jobs in their preferred 1 of 4 regions of the country.
 
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fiji128 said:
"An additional concern identified by both studies involved perceptions surrounding the job market. In an analysis of the 2016-2017 job market, Chowdhary and colleagues found a modest mismatch in the number of job opportunities compared with the number of residents trained in specific geographic regions of the US, particularly in the Northeast9 . Nevertheless, in a separate study Chowdhary and colleagues identified that 75% of residents received job offers in their preferred region10. Valuable additional data are now emerging, such as the ARRO 2020 graduating resident survey reported at ASTRO 2020 which found that 177/179 (98.9%) of graduating residents received job offers prior to graduation, with 89% reporting they were satisfied or very satisfied with their accepted position11. This 2020 resident survey further reported that 73% of graduates were offered first year salaries >$300,000, ranking radiation oncology among the highest paid of the 20 specialties surveyed11. With high satisfaction reported by the majority of graduating radiation oncology residents, job market concerns may in part reflect anxieties perpetuated by a vocal minority on social media. It is valuable for our specialty to recognize the powerful influence of social media, particularly within a small field where a few voices (often posted anonymously) can magnify impressions and concerns for medical students. Real job market data regarding annual job placements will continue to provide a valuable ground truth for students and residents in the field of radiation oncology."

You guys are just posting too much. Plenty of folks finding jobs in their preferred 1 of 4 regions of the country.
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Because of how they defined regions: west included California and Idaho etc.
 
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elementaryschooleconomics said:
Someone should ask the first author of this study about the rumor that his group was looking to replace a retiring partner this year and then decided not to hire after APM dropped.

All rumors, of course, but one I've heard floating around. I'm not entirely sure how you can defend the job market while simultaneously watching/participating in one of the main concerns of the RadOnc market (retiring people not being replaced because of fears over decreased reimbursement).
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Can confirm rumor. Very arrogant group (that really has nothing to be arrogant about)
 
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fiji128 said:
"An additional concern identified by both studies involved perceptions surrounding the job market. In an analysis of the 2016-2017 job market, Chowdhary and colleagues found a modest mismatch in the number of job opportunities compared with the number of residents trained in specific geographic regions of the US, particularly in the Northeast9 . Nevertheless, in a separate study Chowdhary and colleagues identified that 75% of residents received job offers in their preferred region10. Valuable additional data are now emerging, such as the ARRO 2020 graduating resident survey reported at ASTRO 2020 which found that 177/179 (98.9%) of graduating residents received job offers prior to graduation, with 89% reporting they were satisfied or very satisfied with their accepted position11. This 2020 resident survey further reported that 73% of graduates were offered first year salaries >$300,000, ranking radiation oncology among the highest paid of the 20 specialties surveyed11. With high satisfaction reported by the majority of graduating radiation oncology residents, job market concerns may in part reflect anxieties perpetuated by a vocal minority on social media. It is valuable for our specialty to recognize the powerful influence of social media, particularly within a small field where a few voices (often posted anonymously) can magnify impressions and concerns for medical students. Real job market data regarding annual job placements will continue to provide a valuable ground truth for students and residents in the field of radiation oncology."

You guys are just posting too much. Plenty of folks finding jobs in their preferred 1 of 4 regions of the country.
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Every time I read this "diatribe of bilge" my blood pressure rises. But I'm a rad onc and need to be careful; while I know how to treat malignancy, I have no idea how to treat malignant hypertension.
 
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Here's a great idea for the next employment survey. Were you able to find a job in the US, Y/N? Is the job preferable to unemployment, Y/N? Numbers would look great!
 
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fiji128 said:
Here's a great idea for the next employment survey. Were you able to find a job in the US, Y/N? Is the job preferable to unemployment, Y/N? Numbers would look great!
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Did employment consist of an unaccredited fellowship in order to satisfy geographical constraints?
 
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Even when large amounts of residents are unemployed at graduation, they will be able to play with the statistics because some will leave the field and retrain or take part time/locums jobs etc
 
fiji128 said:
It is valuable for our specialty to recognize the powerful influence of social media, particularly within a small field where a few voices (often posted anonymously) can magnify impressions and concerns for medical students. R
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Love the notion that medical students are gullible and stupid and make life changing decisions based on anonymous internet trolls.
 
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yesmaster said:
Graduating residents need to WISE UP when they take these surveys. The surveys are NOT benign!! The surveys are published in IJROBP and then cited by these old fogey chairs to justify the status quo of 200 residency positions per year. Every “satisfied” customer on these surveys is, consciously or not, sabotaging residency contraction and the potential redemption of the radiation oncology job market.
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Totally on point. We need to attempt to have @sueyom curb the publication of these cheap survey projects in the redjournal.
 
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Chirag, Royce, Chowdhary, Goodman et al (and the PGY-5s, ARRO members, brand-new attendings) are the future of this field.

I think this young gen is amazing, I am impressed by them:
- They stand up to the establishment (The establishment = Chairs = think Mitch McConnell, Lindsey Graham et al B****ters).
- They are social media adaptable, they know how to use social media to advance the field in the right direction.
- They are better "listeners" than tone-deaf establishment.

I cannot wait to see these young folks in charge of ASTRO (20 years from now lol)...
 
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Should anybody over 50 be ASTRO president? I have an issue with people with a life expectancy of less than 20 years being in charge of our specialty. These people do not think far ahead. They already made it and want to keep their status quo
 
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RickyScott said:
Because of how they defined regions: west included California and Idaho etc.
Click to expand...

Interestingly when I wrote this paper initially, I felt the amount of grads not receiving a job in their preferred region was pretty high, but I guess it depends on how you read it?

I agree with you @RickyScott @dieABRdie et al - there is significant heterogeneity within regions themselves as well as subregions

For example, much less than 75% of those interested in Pacific (ie California) receiving job offer within that subregion

I am going to write Letter in response to Brower article with subset analysis of subregions
 
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Re maldistribution of MDs: it has been an issue for all specialties for years and years.
The major problems with rural areas:

1. Kids' School System: although the pay is in general higher, the school system is not as good as mid- big cities,
and these are young graduates with kids, they want their kids to be in good school system.

2. Night-life issue: restaurants, music shows, etc. etc. are lacking in rural areas.

3. Nature stuff: In general, lack of access to fun stuff (ski slopes, beaches).

4. So, in general, you can get basic medical fields (such as PCP, OB-Gyn, IntMed etc.) for rural areas by paying them big bucks, but don't expect a HN Cancer Surgeon or a Cardiac Surgeon in small towns bc these are highly specialized people...
Radonc in rural areas usually draw from 60-100 mile radius...
 
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RickyScott said:
Has potters ever had a black resident or faculty member?
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Listen mang, there's lots of shade to be thrown at Louis Potters for the content of his article, but before you try to light him up in this way, takes < 5 minutes to do a quick search and see if there really is something there:

Janna Zeola Andrews, MD | Northwell Health

Janna Zeola Andrews, MD is a New York-based Northwell Health physician who specializes in Radiation Oncology
www.northwell.edu www.northwell.edu

Chika N. Madu, MD | Northwell Health

Chika N. Madu, MD is a New York-based Northwell Health physician who specializes in Radiation Oncology
www.northwell.edu www.northwell.edu

Search for a Northwell Health provider

Search for a Northwell Health provider.
www.northwell.edu www.northwell.edu

That's 3. Out of a department of 21 attendings. 1 out of 7. I'm not sure there's another department in the country that can boast that kind of ratio.

I won't drag down other departments from my < 10 mins evaluating a few academic places (although I will say look at the roster of Paul Harari's own department and see if that's said), but I'll say the man has walked the walk when it comes to diversity within his own department. I think he's wrong to try to drag URMs that don't know jack about SOAP (and I agree with the ARRO article about 'ethical considerations of having a MS4 SOAP into a field that can't guarantee him/her a job 5 years from now), but let's just blast the man for what he HAS done, not what he hasn't.
 
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Oh Evil One,

Do you purport to put African descent physicians in same category as Black Americans? I don’t think a Nigerian American first generation = black American that has been raised for many generations in Us and descended from slaves.
 
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drewdog1973 said:
Oh Evil One,

Do you purport to put African descent physicians in same category as Black Americans? I don’t think a Nigerian American first generation = black American that has been raised for many generations in Us and descended from slaves.
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For better of worse, all blacks are grouped together into URM so the son of an african king is treated just the same as someone from inner city Baltimore or rural Alabama.
 
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Radonc90 said:
Chirag, Royce, Chowdhary, Goodman et al (and the PGY-5s, ARRO members, brand-new attendings) are the future of this field.

I think this young gen is amazing, I am impressed by them:
- They stand up to the establishment (The establishment = Chairs = think Mitch McConnell, Lindsey Graham et al B****ters).
- They are social media adaptable, they know how to use social media to advance the field in the right direction.
- They are better "listeners" than tone-deaf establishment.

I cannot wait to see these young folks in charge of ASTRO (20 years from now lol)...
Click to expand...
Assuming theres anything of value left to be in charge of
 
LP most woke chair ever? Many are now saying it! Future ASTRO president?
 
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evilbooyaa said:
Listen mang, there's lots of shade to be thrown at Louis Potters for the content of his article, but before you try to light him up in this way, takes < 5 minutes to do a quick search and see if there really is something there:

Janna Zeola Andrews, MD | Northwell Health

Janna Zeola Andrews, MD is a New York-based Northwell Health physician who specializes in Radiation Oncology
www.northwell.edu www.northwell.edu

Chika N. Madu, MD | Northwell Health

Chika N. Madu, MD is a New York-based Northwell Health physician who specializes in Radiation Oncology
www.northwell.edu www.northwell.edu

Search for a Northwell Health provider

Search for a Northwell Health provider.
www.northwell.edu www.northwell.edu

That's 3. Out of a department of 21 attendings. 1 out of 7. I'm not sure there's another department in the country that can boast that kind of ratio.

I won't drag down other departments from my < 10 mins evaluating a few academic places (although I will say look at the roster of Paul Harari's own department and see if that's said), but I'll say the man has walked the walk when it comes to diversity within his own department. I think he's wrong to try to drag URMs that don't know jack about SOAP (and I agree with the ARRO article about 'ethical considerations of having a MS4 SOAP into a field that can't guarantee him/her a job 5 years from now), but let's just blast the man for whathe HAS done, not what he hasn't.
Click to expand...
I stand corrected. Didn’t bother to look at website
 
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Fresh off the press from Shauna...

 
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Nah,

We can work for UberEats making $1.7M a year, guaranteed...
 
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thecarbonionangle said:
The breadlines are coming. Pathologists can do derm path. We can do useless “fellowships”
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Sad thing is now fellowships are a sign of failure and not prestige. I’ll be $&-%{* if someone who does a year fellowship in (inset your site here) and looks me in the face and says they are an expert and better than me BC they couldn’t get a job and did a fellowship (peds, brachy, protons exempt). Are there any other fields where a fellowship causes so much disdain?
 
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RickyScott said:
Radonc blew path out of the water.
Click to expand...
My buddy is pd at a well known psych program in the NE and he's been astounded by the change last decade. Used to be a a chunk of fmgs when he first matched, now completely AMGs at his program. Salaries have been going up over the years and they are needed everywhere, geographically.

Guess US medical students aren't that stupid after all...
 
medgator said:
My buddy is pd at a well known psych program in the NE and he's been astounded by the change last decade. Used to be a a chunk of fmgs when he first matched, now completely AMGs at his program. Salaries have been going up over the years and they are needed everywhere, geographically.

Guess US medical students aren't that stupid after all...
Click to expand...
the notion that you should be lucky to have a job in some random undesirable location doesn’t fly.
 
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Harari and his friends argue that we need more medical student exposure. Isn't that the opposite of what is happening? Medical students are aware of what rad onc is through social media, residents, etc. and because of that, they choose NOT to apply because they are so well versed about the field in terms of job market, $$$, and lifestyle. If anything, medical student exposure is at an all time high because US MDs are listening and not applying. If these academic clowns want to continue to fill all these spots, it's probably better for them not to expose med studs to rad onc so they aren't aware of the job market issues and then blindly apply.
 
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Wait, so they have never heard of it “oh, what is that” but also, same sentence, they have heard a lot of people failed an exam ? That sure is interesting ... I talk in detail with facts about things I’ve never heard about, too. Oh wait....
 
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I'm not against more formal presentation of rad onc in the MS 1 to 3 years. Plenty of specialties get no real exposure during those years and they do not have our problems though. I am against it as a way of trying to just drum up more interest in the specialty and maybe a few extra ERAS applications. Paul Harari, Louis Potters and Michael Steinberg are being extremely dishonest or are completely clueless when they see this as some sort of viable path forward.

Medical students are smart and do their research when exploring which specialty to pursue. When you look at rad onc they see a specialty with huge headwinds against it and a declining footprint in oncology. Chairman who needed no data to increase program compliments now claim they want hard data showing they need to contract (and probably wouldn't even if they had that data). No rational person with other great options is going to bet their future one that. The declining interest in the specialty reflects this reality.

If you are still in contact with people in other specialties it is easy to see that rad onc and path have the worst job and career prospects. That is at the root of why high caliber applicants aren't apply like they once did. Now "leadership" like Randall ect... want to reframe the jobs issue as if you have a job, any job that is all you should expect. What a med students see is why would I want to sign up with a specialty where after 9 years of training I will not be recruited to anything and I will have to "network" and hustle just to find a job. Does this happen in any other specialty then path (and maybe ER now)?
 
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drewdog1973 said:
Oh Evil One,

Do you purport to put African descent physicians in same category as Black Americans? I don’t think a Nigerian American first generation = black American that has been raised for many generations in Us and descended from slaves.
Click to expand...

Do I personally put people from those two groups into the same category? Of course not. BUT, they do both fall under the umbrella of URM. ¯\_(ツ)_/¯


I am moving the discussion of systemic racism to the 'Dare You To Reply' thread.
 
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fiji128 said:
I'm not against more formal presentation of rad onc in the MS 1 to 3 years. Plenty of specialties get no real exposure during those years and they do not have our problems though. I am against it as a way of trying to just drum up more interest in the specialty and maybe a few extra ERAS applications. Paul Harari, Louis Potters and Michael Steinberg are being extremely dishonest or are completely clueless when they see this as some sort of viable path forward.

Medical students are smart and do their research when exploring which specialty to pursue. When you look at rad onc they see a specialty with huge headwinds against it and a declining footprint in oncology. Chairman who needed no data to increase program compliments now claim they want hard data showing they need to contract (and probably wouldn't even if they had that data). No rational person with other great options is going to bet their future one that. The declining interest in the specialty reflects this reality.

If you are still in contact with people in other specialties it is easy to see that rad onc and path have the worst job and career prospects. That is at the root of why high caliber applicants aren't apply like they once did. Now "leadership" like Randall ect... want to reframe the jobs issue as if you have a job, any job that is all you should expect. What a med students see is why would I want to sign up with a specialty where after 9 years of training I will not be recruited to anything and I will have to "network" and hustle just to find a job. Does this happen in any other specialty then path (and maybe ER now)?
Click to expand...
On point. There is only one picture needed to sum this up:

Geez - Copy.JPG
 
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As I mentioned before, the vast majority of students doing rotation with me (and my residents) do NOT go into radonc. Out of 100 students doing rotation with us, only 1 or 2 goes into radonc.

For me, since I am an educator, exposure of medical students to radonc serves a different purpose: many of them now possess some key oncology principles that helped them with their future career (Surg, IntMed, Radiology, Pathology etc. etc.)

I did a Nephrology elective as an M3 to learn about acid-base balance and electrolytes. And I am not a nephrologist...

We need radonc exposure to med students: yes.
 
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Radonc90 said:
As I mentioned before, the vast majority of students doing rotation with me (and my residents) do NOT go into radonc. Out of 100 students doing rotation with us, only 1 or 2 goes into radonc.

For me, since I am an educator, exposure of medical students to radonc serves a different purposes: many of them now possess some key oncology principles that helped them with their future career (Surg, IntMed, Radiology, Pathology etc. etc.)

I did a Nephrology elective as an M3 to learn about acid-base balance and electrolytes. And I am not a nephrologist...

We need radonc exposure to med students: yes.
Click to expand...

Agree, we need exposure for the purposes of teaching when and how to consult radiation oncologists

We dont need any exposure for purposes of recruiting any more students
 
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USA grads...

The UK NHS is short of radonc according to Dr Simcock from the UK.
You can move there (get married to a British guy/girl to get UK Citizenship now they are in the middle of Brexit):

 
Radonc90 said:
USA grads...

The UK NHS is short of radonc according to Dr Simcock from the UK.
You can move there (get married to a British guy/girl to get UK Citizenship now they are in the middle of Brexit):

Click to expand...

Can you work as a clinical oncologist in the uk without prescribing systemic treatments?
 
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The man from LIJ said "When in a hole, stop digging..."
Wth is he talking about?

 
Radonc90 said:
The man from LIJ said "When in a hole, stop digging..."
Wth is he talking about?

Click to expand...

My interpretation (and his words) of Louis Potters' commentary is that we have dug a huge hole in radiation oncology in the past years, you stop and throw women and minorities into that hole:
1615655547153.png
 
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