Interview Impressions 2.0

[deleted1002574]

This needs to be updated for the new era. The era is THE BUYER'S MARKET. You deserve honesty, answers, and the truth. If you don't get it, stay away. You can always become a hospitalist, radiologist, medical oncologist, or any other type of doctor. You do not HAVE TO be a rad onc. You will join this once elite specialty on YOUR TERMS not their terms.

I would suggest considering following this format and as you interview, please let other candidates know what's going on. This will help all of you recognize strong programs and weed out the week ones.

Program name - probably the name of thread - that would make the most sense
Total # of residents - __

Questions to ask the faculty AND the residents (ask both to see if the answers match)

What is the chairman's involvement? (Some have a small service and actually teach and some are asked to stay the F*CK away from residents. Who do you want to be your boss?)
Which faculty teach and how do they teach and how much do they teach? Is this a type of program with one teacher carrying the team on their back? Or a squad of teachers?
What are the teaching sessions every week? (didactics, on the ground, oral board sessions, etc.)
How is radiobiology and physics taught? (Repeated annual garbage lectures? Dedicated scientists? Formalized curriculum that makes sense?)
Is everybody passing the boards?
How much resident involvement in cases? (do you see and dictate, do sim, contours or are you a scut monkey?)
Is there double coverage?
Do you go to satellites and for how long?
Explain the didactics/teaching at the satellite
What is the average number of consults per week and what is the breakdown of curative and palliative?
What is the number of SRS/SBRT cases per year?
What is the number of cavitary HDR cases per year?
What is the number of interstitial HDR cases per year?
Research months?
CME time/money? Is it actually usable?
What kind of research is done there by residents and have them highlight their best work? (If it is NCDB analyses, etc., this is not a research powerhouse)
Where have the last few classes of residents gone to work? (They should very easily give you their contact info, if not, that is an issue)
Has any resident left and why? (If they are coy, this is a bad sign)
If program doesn't match will they SOAP?
Are you planning on contracting in the next year or two?
Is there an interview dinner? (if they have one, doesn't tell you much; if they don't, that tells you a lot)
Will they provide lodging for interview? (if you are flying to Jackson, MS or Morgantown, WV, they DAMN WELL better put you up)

Overall Grade
A: Would rank over all other specialties
B: Will rank in between other specialties (i.e. an IM program might be ahead or below)
C: Would rank below other specialties (i.e. all rad onc programs below radiology programs)
F: Would not rank

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[Mandelin Rain]

How many attendings attend and participate in an average didactic session? How many are they expected to lead each year?

What is the mechanism for setting residents up with faculty mentorship to help with professional and research development?

If the resident looks at you like you have two heads, that ain't the program you want.

 

[deleted774703]

Seconded! Please use threads instead of the spreadsheet.

Don’t want ppl to freely mine data for useless self serving publications while saying SDN is bad boo hoo

 

[evilbooyaa]

While I don't agree with every word of this. I completely agree with the overall sentiment that it is a time for applicants to find the best program for them and a lot of these are good points to consider.

Points I disagree with above (starting from the top) or to add onto what was posted above:
I don't think if you don't get answers that means that you completely stay away from the field. It may affect where that specific program ends up on your rank list, along with other factors like geographic preference.
Personal preference on whether this field is the only thing you can see yourself happy in vs if you're deciding between a couple fields.

Not all situations where a chairman does not have a clinical service with residents is a negative, IMO. Some chairs are simply too busy clinically on top of chair duties to effectively teach a resident or are 80% lab-based and residents are better off not being involved with a service that will require coverage of multiple attendings. While it could be a red flag as noted above, it doesn't necessarily mean that it is.

I think evaluation of teaching of RadBio/Physics on a week-to-week basis through residency is honestly overrated. There should be sufficient to pass boards (which 99% of people did this year, and besides that one-year fiasco from ABR has been in the 85-95% range). I, personally, would prefer not to spend 2-3 hours a week every year of residency on this and spend that time on clinical education instead. You need to ask what the pass rates for boards are and what sort of prep time (if any) the program gives prior to those board exams, and what departmental resources are available for the PGY-4s during their (hopefully) dedicated board studying time.

How many satellites do you go to and how far apart are they? Difference between occasionally going to 1 satellite 20 minutes from main facility and 3 satellites that are over an hour or 2 hours apart from each other.

Are there research requirements to meet to get a full complement of research months?

For resident research - if there is a chart review to be done, is there already a database or are residents expected to create those instituional databases? I preferred doing NCDB compared to doing my own institutional chart review. Are residents writing up trial results from attendings that have multiple institutional clinical trials?

As a resident, contraction is actually a bad thinga s there's more call issues.

Ask about how bad call is and how frequently residents are actually coming in on weekends/overnight.

Identify who sees inpatient consults - can attendings without a resident see one or do all of them require resident coverage?



Finally: I second the notion to please use SDN rather than the spreadsheet as we distance ourselves from the vitriol of the interview spreadsheet over the past few years given zero accountability of who posts what there.

 

[deleted1002574]

I meant "stay away" from the program, not the field if you don't get answers. It's a BUYER'S MARKET

About Chairman - I mean, if people say he's sheer evil, it's probably not a good sign. Not saying they should have a service. Just saying it's different than one that is forbidden to see patients or interact with residents

A little bit more call probably not as bad as employment problems, @evilbooyaa??

Good point on inpatients. They continue to be the bane of my existence.

USE THE FORUM, like the boss says!!

 

[evilbooyaa]

Multifactorial on the call bit. If you have two good programs in terms of employability but one will have you there 7 days a week when you're on call and the other one is chill, that can be a tiebreaker. I agree that call at the end of the day is small peanuts but it's a factor.

 

[deleted1002574]

Multifactorial on the call bit. If you have two good programs in terms of employability but one will have you there 7 days a week when you're on call and the other one is chill, that can be a tiebreaker. I agree that call at the end of the day is small peanuts but it's a factor.

I mean for the field overall. If the residencies contract, and call is increased, isn't that overall good ?

 

[TheIllusionist]

I hardly got interviews at top programs (1/13 and 2 waitlists), despite competitive stats. it is less of a buyer's market at the top than one might think. from what it seems like, the mid tier "solid" applicant numbers I think collapsed. I think the elites are still applying in enough numbers.

safe to say, I am IM. I have have better tier IM interviews.

 

[KHE88]

LOL, yup total buyer's market.

Wouldn't be surprised to see departments paying to fly people out, putting them up in hotels, etc. You know, like they do for real employees they are trying to recruit.

At least the malignant programs will be forced to change or go unfilled. (or sadly more likely they will just fill with FMGs).

I mean, I've heard multiple horror stories about Oklahoma, 80 hour weeks full of scut. Not sure how much is true, but who's going to pack up and move to Oklahoma only to have to deal with a malignant residency when you have all these other options.

 

[KHE88]

Finally: I second the notion to please use SDN rather than the spreadsheet as we distance ourselves from the vitriol of the interview spreadsheet over the past few years given zero accountability of who posts what there.

Is there even a spreadsheet this year?
That should be telling, the neurotic kind of people who would make a spreadsheet like we've been seeing have all fled to gun for optho and derm.

The few applicants we have this year and probably all meh or just double applying to another field and don't care.

 

[TheIllusionist]

Is there even a spreadsheet this year?
That should be telling, the neurotic kind of people who would make a spreadsheet like we've been seeing have all fled to gun for optho and derm.

The few applicants we have this year and probably all meh or just double applying to another field and don't care.

I am in the double applying club. But with as badly as I did trying to secure interviews from tip programs, I cannot imagine how badly I would have done 10 years ago. Not sure what I am lacking. But med onc is fine for me

 

[deleted774703]

I am in the double applying club. But with as badly as I did trying to secure interviews from tip programs, I cannot imagine how badly I would have done 10 years ago. Not sure what I am lacking. But med onc is fine for me

Nothing wrong with that.

I also double applied back in the day (though had RO rotations)

Choose the best program that fits what you’re looking for, whatever it may be.

IMO a top RO program > all but top of MO programs

Top MO program > all medium to low RO

Good luck whatever you decide!

 

[medgator]

I mean, I've heard multiple horror stories about Oklahoma, 80 hour weeks full of scut. Not sure how much is true, but who's going to pack up and move to Oklahoma only to have to deal with a malignant residency when you have all these other options.

I knew about WVU, Arkansas and UTenn in recent years, didn't know Oklahoma had one too. Geez

 

[deleted573262]

I hardly got interviews at top programs (1/13 and 2 waitlists), despite competitive stats. it is less of a buyer's market at the top than one might think. from what it seems like, the mid tier "solid" applicant numbers I think collapsed. I think the elites are still applying in enough numbers.

safe to say, I am IM. I have have better tier IM interviews.

still competitive ppl applying, just in lower numbers

 

[evilbooyaa]

I knew about WVU, Arkansas and UTenn in recent years, didn't know Oklahoma had one too. Geez

They've been around since 2007 per Doximity. They have 6 residents total. They're older I believe than all 3 of those other mentioned programs.

 

[medgator]

They've been around since 2007 per Doximity. They have 6 residents total. They're older I believe than all 3 of those other mentioned programs.

Yeah I guess I just missed a bunch during the time I actually was in residency lol. Still I'm impressed with the proliferation of the number of programs over the last decade or so

 

[dieABRdie]

Agree with all the above questions. Maybe a couple other points:

-Another note on inpatient consults: Ask if residents have to cover inpatient consults during their research months? (yes some places do this)

-I think it was mentioned but be sure they offer dedicated board study time... or are residents just too critical to the clinic to be out? There's no way I would have passed without it.

-How helpful are the support staff? Its certainly important to learn how to do everything necessary for the care of the patient, but I'm not sure the femurs I drew as a senior were much better than those I drew as a PGY2... and the time spent wandering all over the department trying to find a computer in order to place an order for a PSA because our nurses refused to do it was probably not useful for my education. As academics begins resembling private practice more and more of these menial tasks will end up in your lap.

-This might seem crazy but ask about whether or not the residents feel they have adequate logistics to do their job. Do they have access to computers at all sites? IT support? Two screens for contouring? Do they have a place to sit??? Yes.... we had one satellite clinic over an hour away where the resident didn't even have a computer to view the patient's chart. Infuriating...

-I would ask about the comprehensiveness of the cases available... and how does the leadership make up for any deficiencies? MANY places don't have adequate pediatric volume. Do they pay for you to go to St. Jude or Jacksonville? Or do residents have to pay out of their own pocket? Or... are residents fudging their case logs to meet the requirement (i.e. double logging).

-Also to re-iterate the point for the resident to be comprehensively involved in the patient's care. I've heard of stories from other residents how they are slammed in clinic all day and at the end of the day they will sit down to work on contours/treatment planning only to find that the plan was already done and signed by the attending without their input. "Don't worry... we'll review it later once the notes are done." If the residents feel like glorified scribes then stay far away.

 

[medgator]

-Also to re-iterate the point for the resident to be comprehensively involved in the patient's care. I've heard of stories from other residents how they are slammed in clinic all day and at the end of the day they will sit down to work on contours/treatment planning only to find that the plan was already done and signed by the attending without their input. "Don't worry... we'll review it later once the notes are done." If the residents feel like glorified scribes then stay far away.

Brings back memories.... But hey at least I BC'ed and got a decent job.

If anyone is deciding to match RO going forward, understanding the existential issues, that's a good list for this buyers market

 

[qwerty89]

still competitive ppl applying, just in lower numbers

Makes sense. You still have plenty of top US students applying who already started radonc related research between their M1-M2 years (as recently as Summer 2017 or even earlier for MD/PhD folks). It's difficult to come to terms with the fact that your intended career isn't going to pan out the way you wanted. Most will just plow ahead and hope for the best.

It is when the incoming med students start applying for residencies that the quality will really start to suffer. Those guys won't start med school looking at radonc with the same rose colored glasses.

 

[medgator]

Makes sense. You still have plenty of top US students applying who already started radonc related research between their M1-M2 years (as recently as Summer 2017 or even earlier for MD/PhD folks). It's difficult to come to terms with the fact that your intended career isn't going to pan out the way you wanted. Most will just plow ahead and hope for the best.

It is when the incoming med students start applying for residencies that the quality will really start to suffer. Those guys won't start med school looking at radonc with the same rose colored glasses.

Good points. It won't take us nearly as long for us to be back to circa 1994-1996 quality RO applicants in the age of SDN and Twitter

 

[deleted573262]

Good points. It won't take us nearly as long for us to be back to circa 1994-1996 quality RO applicants in the age of SDN and Twitter

it should only take a year or two more until the avg step scores are in the 230's and research / pubs is less than 10.

 

[medgator]

it should only take a year or two more until the avg step scores are in the 230's and research / pubs is less than 10.

I was thinking that is what this year's applicant class probably had...

 

[xrthopeful]

The applicants are quite strong this year still. Will see what the downstream affects are in future years

 

[medgator]

The applicants are quite strong this year still. Will see what the downstream affects are in future years

Only so many to go around....

 

[xrthopeful]

Only so many to go around....

True

 

[thecarbonionangle]

Agree with all the above questions. Maybe a couple other points:

-Another note on inpatient consults: Ask if residents have to cover inpatient consults during their research months? (yes some places do this)

-I think it was mentioned but be sure they offer dedicated board study time... or are residents just too critical to the clinic to be out? There's no way I would have passed without it.

-How helpful are the support staff? Its certainly important to learn how to do everything necessary for the care of the patient, but I'm not sure the femurs I drew as a senior were much better than those I drew as a PGY2... and the time spent wandering all over the department trying to find a computer in order to place an order for a PSA because our nurses refused to do it was probably not useful for my education. As academics begins resembling private practice more and more of these menial tasks will end up in your lap.

-This might seem crazy but ask about whether or not the residents feel they have adequate logistics to do their job. Do they have access to computers at all sites? IT support? Two screens for contouring? Do they have a place to sit??? Yes.... we had one satellite clinic over an hour away where the resident didn't even have a computer to view the patient's chart. Infuriating...

-I would ask about the comprehensiveness of the cases available... and how does the leadership make up for any deficiencies? MANY places don't have adequate pediatric volume. Do they pay for you to go to St. Jude or Jacksonville? Or do residents have to pay out of their own pocket? Or... are residents fudging their case logs to meet the requirement (i.e. double logging).

-Also to re-iterate the point for the resident to be comprehensively involved in the patient's care. I've heard of stories from other residents how they are slammed in clinic all day and at the end of the day they will sit down to work on contours/treatment planning only to find that the plan was already done and signed by the attending without their input. "Don't worry... we'll review it later once the notes are done." If the residents feel like glorified scribes then stay far away.

so many places like this sadly where resident education is the last thing in people’s mind and you are just a warm body. Half of current programs Or even more should probably be shut down