Hellpits- absolute worst programs in radiation oncology

[RickyScott]

Want to chime in with respect to Pitt - I have a friend in residency there, and it sounds like the culture has improved vastly under the new chair.

Don’t know much abt the program but w/ huge hospital system and department, as good a place as any, if foolish enough to choose radonc.

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[deleted1111261]

Great
Now that I don’t have to look for a job, reputation is improving

 

[elementaryschooleconomics]

Great
Now that I don’t have to look for a job, reputation is improving

Oh yes, you are well known for not looking for jobs. Great news indeed.

 

[HemeOncHopeful19]

Great
Now that I don’t have to look for a job, reputation is improving

Just think of it as you getting out there and being in practice is what helped improve the reputation! 💪🏻

 

[Mandelin Rain]

Great
Now that I don’t have to look for a job, reputation is improving

You graduate and reputation improves? Coincidence? I'm just asking questions here.

EDIT: Damn, someone beat me to it.

 

[metallica81788]

Once you are out in practice for 3-4 years, shouldn't where you trained not really matter in terms of finding a job? Besides for the ever important networking aspect of course.

 

[NotMattSpraker]

Once you are out in practice for 3-4 years, shouldn't where you trained not really matter in terms of finding a job? Besides for the ever important networking aspect of course.

I think it matters very little for clinical skills.

It does matter a little due to networking like you said.

But also if you have a big name on the CV it probably helps get you attention among a large pile of CVs. Its unfortunate but seems true across settings in my experience.

 

[sirspamalot]

Yeah it matters still. A lot.

I know 'whats expected' at Stanford, WashU, MSK, MDACC etc. I know those folks have been trained. Not sure about dem hellpits doe.

Sure maybe 'everyone' gets better in practice.. but.. that also depends where you practice.

Also, I'm a snob elitist... sigh. No, well, maybe just a bit.

But honestly, you can be from superduper whatever and if you're an Ahole.. then no, I don't wanna work wit ya

 

[yesmaster]

Ah yes, nothing quite like the sight of morning light striking my top 3/5/10 residency diploma at the perfect angle as I sip my morning brew seasoned with pedigree nutmeg

 

[sirspamalot]

I needed that chuckle, thank you. I am done sipping my organic swiss-water decaff pure arabica highlands mexican grown coffee...

 

[evilbooyaa]

C'mon guys.

With zero sarcasm - I encourage you all to be a little bit more thoughtful. Comparing any radiation oncology residency to pornography.... poor taste. Posts deleted. Further discussion along that thread will lead to warnings.

 

[TheWallnerus]

Can we define a "hellpit"? Hmm.

 

[TheWallnerus]

C'mon guys.

With zero sarcasm - I encourage you all to be a little bit more thoughtful. Comparing any radiation oncology residency to pornography.... poor taste. Posts deleted. Further discussion along that thread will lead to warnings.

oh btw, that observation (in defense of the poster's First Amendment rights!) was not comparing porno and a residency, it was a riff on the inchoate nature of defining bad residencies based on the semi-absurdist observation by a Supreme Court Justice.

 

[thesauce]

What has always amazed me is when a hospital hires some new grad from a hellpit because it was the only person they could get and then they turn around and market the person like they are the best physician ever.

I’m between shock that they would try to fool
the public and shock that the public is so easily fooled.

 

[medgator]

What has always amazed me is when a hospital hires some new grad from a hellpit because it was the only person they could get and then they turn around and market the person like they are the best physician ever.

I’m between shock that they would try to fool
the public and shock that the public is so easily fooled.

Fake it till you make it

 

[drowsy12]

What has always amazed me is when a hospital hires some new grad from a hellpit because it was the only person they could get and then they turn around and market the person like they are the best physician ever.

I’m between shock that they would try to fool
the public and shock that the public is so easily fooled.

I am quite confused by this, it sounds pretty elitist/Wallner adjacent.

Hospitals market regardless for one. For two, the idea that someone who didn't train at a top program is lesser than or less worthy of taking care of cancer patients is also strange.

 

[RickyScott]

sw

I am quite confused by this, it sounds pretty elitist/Wallner adjacent.

Hospitals market regardless for one. For two, the idea that someone who didn't train at a top program is lesser than or less worthy of taking care of cancer patients

This is not 2010. I honestly would question the judgement and “worthiness” of non-fmg hellpit grads. There is no excuse for an American grad choosing a Hellpit program today other than substance abuse, and perhaps now got their life back together. Today, we do have to answer-does lack of judgement in choosing radonc mean you shouldn’t be taking of cancer patients

 

[drowsy12]

sw

This is not 2010. I honestly would question the judgement and “worthiness” of non-fmg hellpit grads. There is no excuse for an American grad choosing a Hellpit program today other than substance abuse, and perhaps now got their life back together.

This is certainly a take. wow.

 

[RickyScott]

This is certainly a take. wow.

Ok, I will take the bait-what is a good reason an American md would choose a hellpit over a “top 25” type program? (There is a spot for everyone somewhere in the upper echelon programs)

Perhaps, the applicant was geographically driven? (which would make him a total ***** for applying to this field)

 

[thesauce]

I am quite confused by this, it sounds pretty elitist/Wallner adjacent.

Hospitals market regardless for one. For two, the idea that someone who didn't train at a top program is lesser than or less worthy of taking care of cancer patients is also strange.

When I read your first sentence, I assumed you were acknowledging that the hospital was elitist - because that’s exactly what’s going on. It is the hospital who is putting out the propaganda that their brand new grad from the hellpit is better (never heard them say equal) than the current people in the market. Not the other way around.

 

[NotMattSpraker]

I am quite confused by this, it sounds pretty elitist/Wallner adjacent.

Hahaha Im going to start openly calling elitist comments "Wallnerian".

Kinda ironic, hes a DO who entered the field in the pre-IMRT era. Maybe this is just his response to decades of DO abuse. We have a very functional RadOnc family.

 

[sirspamalot]

Hahaha Im going to start openly calling elitist comments "Wallnerian".

Kinda ironic, hes a DO who entered the field in the pre-IMRT era. Maybe this is just his response to decades of DO abuse. We have a very functional RadOnc family.

Boy do we ever..

 

[yesmaster]

The idea of hellpits or top/bottom programs was problematic in 2005 and is still problematic today.

In 2005 it’s problematic because you could tell that top academic SCAROP people didn’t give a **** about community docs, in fact they’d love to eat their lunch. Expansion to erode the livelihood, bargaining power, and independence of community docs makes lots of sense here.

Now in 2023, if you talk to a dermatologist, ophthalmologist, heme onc, subspecialist surgeon, you don’t ask what program they trained at. S/he is a dermatologist, they’re killing it, end of story.

In 2023, we only feel the need to stratify programs and rad oncs because frankly, there’s not enough work or patients to go around. Compare that to fields with tremendous demand for physician services, like dermatology, anesthesia, heme onc. There’s none of that top 3/5/10 nonsense, they’re all doing well.

 

[yesmaster]

Frankly, I would love to see the bottom 40 programs fail to fill or SOAP, because of our overtraining problems. Of course, I’d also love to see the top 25 programs fail to fill or SOAP.

Like Einstein once said, I’m all about the numbers babe.

 

[sirspamalot]

Frankly, I would love to see the bottom 40 programs fail to fill or SOAP, because of our overtraining problems. Of course, I’d also love to see the top 25 programs fail to fill or SOAP.

Like Einstein once said, I’m all about the numbers babe.

Like the Kool-aid Jug says...

OH yeah...

 

[communitydoc13]

Hahaha Im going to start openly calling elitist comments "Wallnerian".

Kinda ironic, hes a DO who entered the field in the pre-IMRT era. Maybe this is just his response to decades of DO abuse. We have a very functional RadOnc family.

Wallner felt the need to explain his DO in interviews (my opinion is he should have owned it). He is old enough to have experienced admissions quotas.

But the most important thing about Wallner's bio is that he had lots of non-clinical time early in his academic career.

The hellpits? I don't know. But a big part of oversupply was growth of large and prestigious departments. The opportunities for their own graduates became collectively worse as they did this.

I am pretty confident that regarding some of the more technical aspects of being a radonc, some smaller and less prestigious places offer better training than some of the big name programs.

 

[evilbooyaa]

sw

This is not 2010. I honestly would question the judgement and “worthiness” of non-fmg hellpit grads. There is no excuse for an American grad choosing a Hellpit program today other than substance abuse, and perhaps now got their life back together. Today, we do have to answer-does lack of judgement in choosing radonc mean you shouldn’t be taking of cancer patients

I mean you're primarily just discriminating against international grads and certain programs. It's not really cool that you are but it's never going to be something that is proven in a lawsuit. You can certainly have your opinion that you'll never hire an international grad or a DO or someone who trained at a hellpit, even if it's a pretty **** one, IMO. It really just ties into blaming a medical student for making a 'poor' residency decision rather than the powers that be from still offering a program.

The problem will hellpits isn't the residents who come out of them, it's the fact that their training is mostly self-directed as they have a paucity of appropriate faculty to learn from...

 

[thecarbonionangle]

i have said this on here many times. The issue with the hellpits is not the residents (at least not yet). People are smart and find a way to learn (Astro refreshers, nancy lee, CCF book, osler course etc). The issue with the hellpits is that they just use residents for warm body cheap labour. the residency educational experience is very poor. The culture is exploitative and non-collegial. In these times, someone has got to get cut and shut down. It really is quite simple. These places will continue to fill in SOAP without any regard to health of field or without ethical concerns about soaping a vulnerable student who failed to match other fields. They are a huge problem which cannot be ignored. We need to drastically cut numbers of residents. Sorry about your “feelings”.

 

[RickyScott]

I mean you're primarily just discriminating against international grads and certain programs. It's not really cool that you are but it's never going to be something that is proven in a lawsuit. You can certainly have your opinion that you'll never hire an international grad or a DO or someone who trained at a hellpit, even if it's a pretty **** one, IMO. It really just ties into blaming a medical student for making a 'poor' residency decision rather than the powers that be from still offering a program.

The problem will hellpits isn't the residents who come out of them, it's the fact that their training is mostly self-directed as they have a paucity of appropriate faculty to learn from...

I wouldn’t discriminate against an international grad from a hellpit, just an American MD.

 

[medgator]

i have said this on here many times. The issue with the hellpits is not the residents (at least not yet).

30+ in the soap every year for multiple years now with stories of PGY-2s being unable to secure even prelim surgery spots?

Going to have to agree to disagree

 

[thecarbonionangle]

30+ in the soap every year for multiple years now with stories of PGY-2s being unable to secure even prelim surgery spots?

Going to have to agree to disagree

Im talking about people who are out practicing and BC. Pretty soon the new crop will be looking for a job and i would argue you should scrutinize all new grads, not just hellpits at that point. The competitiveness of the field has gone down significantly and a lot of places have reduced standards just to stay out of soap, so only focusing on the soapers isn’t the full story. The truth is even the hellpit grads in the recently competitive times, were quite qualified and accomplished. This field is great at wasting talent.

 

[sirspamalot]

This field (leadership) sucks.

 

[thecarbonionangle]

This field (leadership) sucks.

Worst “leadership” out of any field in medicine. Someone prove me wrong please

 

[Ray D. Ayshun]

Worst “leadership” out of any field in medicine. Someone prove me wrong please

Tough to prove worst. I would feel comfortable saying our leadership is not noninferior.

 

[thecarbonionangle]

Tough to prove worst. I would feel comfortable saying our leadership is not noninferior.

This is great for SCAROP. We conducted a study and showed our “leadership” is “noninferior” so SDN misanthropes are fake news

 

[StIGMA]

The problem will hellpits isn't the residents who come out of them, it's the fact that their training is mostly self-directed as they have a paucity of appropriate faculty to learn from...

That means that the resident turned new attending is a problem from deficient training. Whether they had the potential to be better or not is a moot point.

 

[elementaryschooleconomics]

Tough to prove worst. I would feel comfortable saying our leadership is not noninferior.

For those looking to really dig into the methods, we defined "non-inferior" as no more than 40% worse than the leadership provided in 1812 by Napoleon when he decided to invade Russia in winter.

 

[thecarbonionangle]

That means that the resident turned new attending is a problem from deficient training. Whether they had the potential to be better or not is a moot point.

If someone trained in a bad learning environment and passed the same tests you did and are practicing competently as assessed by their peers, are they still deficient? What criteria will you use to determine this? i have interacted with people from “top” places who did not impress me.

Im just trying to add some nuance to my opinion. I think bad learning environment places should shut down because they are simply not fulfilling their fiduciary responsability to society, that is to educate. Of course with declining quality of applicants and lowering standards, the field will come back full circle to its IMG roots and we will all be hurt by this. The entire field is to blame and not just hellpits. Many places have lowered standards to avoid the soap.

 

[thecarbonionangle]

For those looking to really dig into the methods, we defined "non-inferior" as no more than 40% worse than the leadership provided in 1812 by Napoleon when he decided to invade Russia in winter.

The russians have had this situation many times in history, that invaders are dumb enough to attack during winter, i believe but correct me if im wrong, certainly not a russian war scholar

 

[sirspamalot]

avoid the soap.

Funny that this advice sounds similar to one who goes to jail.

 

[thesauce]

Funny that this advice sounds similar to one who goes to jail.

A lot of similarities here

 

[evilbooyaa]

That means that the resident turned new attending is a problem from deficient training. Whether they had the potential to be better or not is a moot point.

Tons of good Rad Oncs come from not great programs. If the resident passes boards, who are you to judge their capabilities? Sounds like some elitist bull****, honestly.

 

[RickyScott]

Tons of good Rad Oncs come from not great programs. If the resident passes boards, who are you to judge their capabilities? Sounds like some elitist bull****, honestly.

I think it is more abt judging their judgement. It is bad judgment for an American MD to choose radonc to begin with and it is even worse to turn down bigger name programs. (Btw I am a proud hellpit grad- perfect residency)

 

[sirspamalot]

It is bad judgment for an American MD to choose radonc to begin with

 

[StIGMA]

Tons of good Rad Oncs come from not great programs. If the resident passes boards, who are you to judge their capabilities? Sounds like some elitist bull****, honestly.

I think it's naïve to assume everyone is good at most everything. Passing boards is attaining an agreed upon minimum. I think we can also agree that with the right training/internal motivation, we can all learn to do things better (ie: not starting from great).

 

[sirspamalot]

 

[evilbooyaa]

I think it is more abt judging their judgement. It is bad judgment for an American MD to choose radonc to begin with and it is even worse to turn down bigger name programs. (Btw I am a proud hellpit grad- perfect residency)

I'm going to maintain that that's a bad take. It's impossible to know the motivations of an American MD in creating a rank list for Rad Onc, because there is STILL an information asymmetry given that most of non-SDN probably tells people to not listen to the bad apples of Rad Onc (who exist solely on SDN). So a med student who ends up at a hellpit for RO residency may have options that were less 'hellpit' but really wanted to stay in a specific region, or had a sick family member, or something, something that made them put the hellpit higher than 'a big name program (a lot of which at least sound super malignant if you saw the Twitter thread on MSKCC RO residency recently), and that needs to come with a realization that you really just don't know the story behind their life.

But, it's a free country, so do whatever *******ery that you want.

 

[medgator]

I'm going to maintain that that's a bad take. It's impossible to know the motivations of an American MD in creating a rank list for Rad Onc, because there is STILL an information asymmetry given that most of non-SDN probably tells people to not listen to the bad apples of Rad Onc (who exist solely on SDN).

Really? Not hard for a med student to look at spots offered now vs a decade or two ago and see that many more are offered now, along with RO being bottom of the barrel for SOAP 3 years in a row now.

Not normal things and certainly would require more investigation than just jumping in headfirst

 

[sirspamalot]

If you're a med student and haven't* done the minimum research to understand (in the modern internet era) what you are getting into, I'm not going to feel sorry for you.

 

[evilbooyaa]

Really? Not hard for a med student to look at spots offered now vs a decade or two ago and see that many more are offered now, along with RO being bottom of the barrel for SOAP 3 years in a row now.

Not normal things and certainly would require more investigation than just jumping in headfirst

There are literally articles in prominent journals by academic Rad Oncs suggesting that medical students are dummies who just do and like things because others do... so we know that like real, adult, attending physicians, believe dumb **** like that. Are you suggesting that medical students, who don't have the life experience to know who is a snake oil salesman (is it SDN or the folks claiming everything is OK), should be doubly punished for information asymmetry? As a medical student, would you rather trust a prominent academic Radiation Oncologist, or some anonymous shmuck on the internet who may not even be a Rad Onc, and if he is, may be a Rad Onc at some garbage rural or community hospital just mad about more competiton to come steal his money?

It's very easy for regular members here to get very caught up and be knowledgeable about these things.

Radiology and Anesthesiology were routinely in the SOAP when I was applying to Residency.... both of them look pretty good now for attendings. Many may assume the same circular nature to Rad Onc. I'm not saying I believe that, but punishing medical students for not holding SDN's viewpoints is NOT the answer I recommend here.