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Yeah, the problem is that you could sunset and close down all but the top-5 residency programs nationwide starting this year and still be well oversupplied for 2 decades.
[Global warming argument]Yeah, the problem is that you could sunset and close down all but the top-5 residency programs nationwide starting this year and still be well oversupplied for 2 decades.
Repeating. ASTRO is a membership organization. More graduates equals more dues...really very simple. Most ASTRO leadership needs cheap labor (residents) and low salaries...It's really shocking how bad astro has been on this issue. They have essentially maintained a position that they do not want to seriously study or even know about the number one issue that has the largest effect on its membership for the past 10 years. Instead you get publication of dyi surveys to support whatever it is you want to see, choosing wisely campaigns, RT omission trails and of course anti-trust arguments.
I just don't know what happened now vs 2 decades ago when they actually did try to fix the problem and spots did go down.... guess the boomers just got more selfish...Yes the interest of Astro is more docs so more dues. And astro is run by a club of exclusivity - older, connected physicians, in power, with careers of 5 years or less and enough income and years earned anyway they could retire tomorrow without it effecting them.
Yes it is a hard pill to swallow to not pay ASTRO dues and not have the PAC, but we are so outspent by pharma anyway it barely matters, and the RO APM just proves how uneven cuts will be in the oncology sphere to us.
So I stopped paying. Still buy virtual product, singular, per year. But our own physician organization doesn’t advocate at all for me as a physician in the field. So lesson learned. They will still get all the resident fees from the expanded programs, they still win. SOAPing 40 people is a financial win for Astro, even if it stuffs the field with people who have no interest in oncology care, and some people whose aptitude in medical school was so poor they couldn’t match anywhere else. And the bitterness and divisions in the field will amplify, and the cuts will keep happening to the newer entrants, while the old guard will be unaffected. Leadership is out of touch with the field, because their bottom line and take home pay is improved by taking maximum advantage of us.
Boomers going to boom.I just don't know what happened now vs 2 decades ago when they actually did try to fix the problem and spots did go down.... guess the boomers just got more selfish...
It had the potential to affect them then. It won’t now.I just don't know what happened now vs 2 decades ago when they actually did try to fix the problem and spots did go down.... guess the boomers just got more selfish...
heard that is what David Beyer's group did in Phoenix, and then last year he is tweeting what a fantastic future our field has after pocketing tens of millions like Michael Steinberg following his own sell out.It had the potential to affect them then. It won’t now.
Not to belittle RadOncs situation. Radiology is going through it’s own crisis of this sort from boomer groups selling to private equity. Lots of jobs but a lot of them are trash.
of course the ACR says nothing about the predatory groups lying to graduates and then selling to RP or USRS before anyone makes partner.
I’m sure you guys know better than me, but honestly radonc and IR should merge. Or Radonc should close all residencies and become a radiology (or medonc) fellowship.
I just don't know what happened now vs 2 decades ago when they actually did try to fix the problem and spots did go down.... guess the boomers just got more selfish...
I get it, the authors should have latitude in their publishing as to bring in new ideas and stimulate discussion. I agree with that all day, everyday.Let me defend for Sue (to be EIC later ~ Jan 2020) and RedJ...
- A journal, whether it is Am J of Surgery or JAMA or NEJM, is just a platform where people publish their studies or thought process (letters to editors). It is important to have a mix of opinions. Just like our country, it is good to hear from both the Republicans and the Democrats (and the Indy's). The more opinions the better. I thought Goodman et al was spot on. Potters' rebuttal is Potters'. The writings, whether it is scientific or debate on our field oversupply issue, reflect the author(s)' opinions and not those of RedJ. RedJ in a way is like Twitter, it is a platform for sharing info. Your tweets belong to you and reflect what you say, and it does not reflect Twitter's view. Unless you help incite violence on Jan 6, then Twitter will ban you lol...
- So if one has issues with Potter's rebuttal, then write to RedJ or go to Twitter, it does not matter to me where you write it. Potters' writing show the world his true skin color. The absence of white men response on Twitter is deafening...
- URM has nothing to do with oversupply. The issue of URM (which I strongly support) existed in the 1980s, 1990s when we had only 110 PGY-5's/yr. Now with 180 PGY-5's /yr, same issue.
- ASTRO talks about URM bc they need to "look good".
- So Sue is correct.
- I embrace URM a different way. If I see a URM M4 desperate to get into Urology, I pick up the phone and call my buddy Urology PD. If I see a URM M4 desperate to get into Ophthalmology, I pick up the phone and call my buddy Ophthalmologists at Hopkins and all that blah blah blah...You help them in anyway you can, and trust me, they will remember you for life...
I believe there are a group of people, currently penning a letter in response to the Potters' letter (personal communication ).I think you should write a rebuttal to Potters' letter and submit to RedJ.
No peer review needed for opinion letters. The main difference between "letters" to a journal and Twitter or anonymous forum like here is that personal professional capital matters in terms of who gets published in journals and matters only in terms of response on Twitter. I prefer anonymous forums because personal professional capital matters none (unless you choose to be identifiable).Was there a peer review?
This is a damned if you do damned if you don’t situation.Despite being a womanwhocuries, I have found some of ASTRO's push on gender issues to be over the top and disingenuous. The silence from the womenwhocurie twitterati on Potters incredibly offensive comments about how women couldn't match before due to competitiveness is deafening.
Per Potters "This is a glass half full that gives us the space needed to fix many aspects of our specialty. It is an opportunity to bring in great clinicians as well as great researchers and to attract more minorities and women."This is a damned if you do damned if you don’t situation.
See pub below in PRO. It’s saying step 1 scores affect diversity, but it’s written be URM as first author and lauded on Twitter as yea that’s right. When a white chair says the same thing it’s the end of the world. Unfortunately, this is all 100% predictable and 0% surprised. Someone forgot to tell Potters the rules of the game. Now, the DIE crew all up in roar when someone else points out the “step 1 problem.” There is no winning here, especially for Rad Onc. One thing we all agree on though is that using diversity now to recruit URMs at such a low point is despicable.
Overemphasis of Step 1 Scores May Affect Application Pool Diversity in Radiation Oncology - PubMed
Overemphasis of Step 1 scores may reduce the diversity of the radiation oncology applicant pool. Further evaluation of practices that counter the stated American Society of Clinical Oncology, American Society of Radiation Oncology, and American College of Radiology diversity missions should be...pubmed.ncbi.nlm.nih.gov
With some very simple math you can derive some very simple solutions to what at heart is a very simple problem.Given the numbers of 1 radonc per 100,000 people. Country is currently at 330000000. Average work life of a RadOnc ~40 years.
330000000/100000/40=82.5 spots per year. Let it rest and see where population growth and decreased utilization is going and then reassess in 10 years.
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
Check the response by radiologists to resident shortage in the article below. Not sure what is going in their market, but man do we have to go to congress to decrease spots in rad onc? Say something like "There is an 'alarming' misuse use of resident allocation into radiation oncology. We need to be able to have an external mechanism to close spots other than relying on the arbitrary discretion of chairs."
"Rep. Terri Sewell, D-Ala., introduced the House bill last month alongside Reps. John Katko, R-N.Y., Tom Suozzi, D-N.Y., and Rodney Davis, R-Ill. Sewell noted that the proposal would support an additional 2,000 positions each year from 2023-2029 for a total of 14,000 positions. Absent any legislation action, the U.S. could face a doc shortage of upward of 121,300 by 2030, experts noted."
American College of Radiology backs bipartisan push to address ‘alarming’ resident physician shortages
Lawmakers recently introduced the Resident Physician Shortage Act of 2021 to address doc shortfalls by bolstering the number of Medicare-supported residency positions.www.radiologybusiness.com
Here's my future radiology reads:Maybe if their shortage becomes bad enough they would allow radiation oncologists to do an abbreviated redistribution into diagnostic radiology when we have no jobs left. Cross your fingers folks.
This would be the correct read for a penile cancer.Here's my future radiology reads:
"There may or may not be a mass in XYZ organ. It appears to be slightly smaller or bigger, perhaps stable. Clinical correlation is recommended."
Gimme that RVU baby!
New opacity in the left lung base -cannot rule out extraterrestrial infection.I never understood why rads was such a long training. All you have to do is learn not to answer phones
AI probably hard at talking to cancer patients and doesn't respond well to presuit letters.... Right?Re Radiology shortage...
- Is there a shortage of radiologists?
- Radiology and Derm, the 2 visual fields, IMHO, will be affected by Artificial Intelligence the most.
AI can now read low-dose lung screening very well with high accuracy ---> lessening the need for radiologists.
Some Derm AI softwares are very advanced, take a photo of the skin lesion, upload to a program, the diagnosis is very accurate.
- Whatever it is, AI will vastly transform medicine, for better or worse...
Biryani is pretty pretty pretty good.Do any of you think that reduction in spots will happen before significant unemployment?
Saw CC PD post about how he gave the option to keep residency spots to the applicants, and they voted yes, so he didn't reduce any spots. But, obviously CC will fill, just committing to not SOAP people who had no interest in RadOnc won't work because it's typically the programs that know they will fill. Seems like most programs will fill regardless even with the concerns about the future job market. From the data I've seen it does not look like very many programs (maybe top 5?) should have >=3 residents/year with how many docs are coming and the decreasing needs for radiation, unless there is something that can significantly increased work for radoncs (meds, more indications, truck driving apparently).
I've recently tried Biryani, and it is pretty good. Plz give job to buy more.
To the Radiology topic, I've talked to some pretty well known people in Diagnostic Radiology, none of them seems to think AI will negatively impact their job market.
I do not think that reduction in spots will happen before significant unemployment. MAYBE if the Twitterati had taken notice when the issue was originally brought to light. They did not.Do any of you think that reduction in spots will happen before significant unemployment?
Saw CC PD post about how he gave the option to keep residency spots to the applicants, and they voted yes, so he didn't reduce any spots. But, obviously CC will fill, just committing to not SOAP people who had no interest in RadOnc won't work because it's typically the programs that know they will fill. Seems like most programs will fill regardless even with the concerns about the future job market. From the data I've seen it does not look like very many programs (maybe top 5?) should have >=3 residents/year with how many docs are coming and the decreasing needs for radiation, unless there is something that can significantly increased work for radoncs (meds, more indications, truck driving apparently).
I've recently tried Biryani, and it is pretty good. Plz give job to buy more.
To the Radiology topic, I've talked to some pretty well known people in Diagnostic Radiology, none of them seems to think AI will negatively impact their job market.
Me too. If anyone has an account on 'Frank,' they should search for khe88.I really, really miss KHE88. I wonder how he is. I wonder if he’s found new employment in another rural area.
Can’t wait for the “masterclass” in leadership at this years Astro. Wasn’t going to attend but would change my mind if they offer one. Few years ago they had a leadership training conference- anyone know if they will be offering it again?I do not think that reduction in spots will happen before significant unemployment. MAYBE if the Twitterati had taken notice when the issue was originally brought to light. They did not.
Asking your residents whether or not to expand or contract your residency program makes zero (0) sense to me. Academic leaders are supposed to do just that- lead. Make the tough decisions yourself.
I'd pay money to go to that too, hopefully they have Potters Steinberg and the chair of WVU show upCan’t wait for the “masterclass” in leadership at this years Astro. Wasn’t going to attend but would change my mind if they offer one. Few years ago they had a leadership training conference- anyone know if they will be offering it again?
If I never went to class in medical school, why would I want to attend an in-person medical conference?Is ASTRO even happening this year? Anybody heard anything?
My main motivation is to not leave a single cent on table for greedy chairmen. Gonna use every cent of that CME money brotha!If I never went to class in medical school, why would I want to attend an in-person medical conference?
My main motivation is to not leave a single cent on table for greedy chairmen. Gonna use every cent of that CME money brotha!
I am going to give this a try.CME Online - Earn CME Hours for Physicians, PAs, and NPs
Earn up to 100 CME hours online! Meet your annual requirements quickly and easily with Continuing Medical Education credits for physicians, PAs, and NPs.www.boardvitals.com
I only see rads not ROCME Online - Earn CME Hours for Physicians, PAs, and NPs
Earn up to 100 CME hours online! Meet your annual requirements quickly and easily with Continuing Medical Education credits for physicians, PAs, and NPs.www.boardvitals.com
There's other ones out there, that was the first one i rememberedI only see rads not RO
Why stop at residencies when you can have a medical school and why not a nursing school:One reason to increase residency program requirements is to prevent HCA from getting involved in rad onc training. These HCA programs have started popping up in radiology, derm, plastics, and even NuSu.
One reason to increase residency program requirements is to prevent HCA from getting involved in rad onc training. These HCA programs have started popping up in radiology, derm, plastics, and even NuSu.