medstudents entering the match

[Mandelin Rain]

Not to mention.... How exactly are med oncs in this country magically going to start looking at their own scans for treatment planning? Or magically learn rt tolerances etc. Or is a diagnostic radiologist going to all of a sudden start an oncology clinic? Skillsets are totally different.

I mean, the obvious answer is the med onc would be in the clinic and the radiologists would look at the scans, rather than vice versa with both reinventing the wheel.

I'm not saying it's incredibly likely, just that I could see it. Especially if med onc become the pay masters for oncologic care in this country, as has been bandied about. They wouldn't want some other doctor having an opinion on how the patient's finite payment pie is split.

And let's be honest. It's not too hard to contour a prostate (or any organ). Literally any radiologist could do it today. If not them, then an AI software package. Dosimetrists and computer algorithms plan the actual treatment. There are fairly standardized dose constraints for most sites. These all live in a computer nowadays, and with a glance you can tell if they are met or not. Newer softwares may actually spit out what the likelihood there is of damaging an organ based on the plan. For the treatment delivery, we just had data shown on this site that computer matched IGRT is better than human matched IGRT. And we're developing better tech for matching anyway (fiducial based, MR based, SUV based). Guess who can place fiducials? Symptom management during treatment? Med oncs can handle prescribing Flomax, Magic Mouthwash, and IVFs.

As we transition to shorter and shorter courses, with a greater reliance on tech, our role as human physicians diminishes further and further.

I'll just say it wouldn't shock me if rad onc became a 1-2 year fellowship to radiology or an adjunct to IR or something at some point in the future. The rads killed Nuc Med. They own our boards.

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[w00tz]

I could see radiology and Med Onc collectively taking our role. PET and MRI guided IGRT with auto match. AI to contour. Computers to plan with NTCP based dose limits. It's all pretty automated already. Especially as we move toward tinier volumes and shorter courses.

Med Oncs become "Oncologists". They "order" radiation. Patient gets a scan and rads/computers do the rest. Med onc handles toxicity, etc...

Aside from med oncs that sub-specialize in a subsite, I think a growing problem for them is keeping up with all the advances that have made in the last 5 years with immumotherapy and targeted therapy. I see some med oncs getting burned out because of this feeling of falling behind and struggling to keep up. I doubt they could also juggle keeping up with ongoing advances in radiation oncology as well. Not to mention the upfront learning/additional training would be another major hurdle.

 

[MegaVoltagePhoton]

Residency expansion has been an unforgivable sin.

But I have to say, the people on here who constantly denigrate what they themselves do...I can't understand why. I'm sorry if all you bring to the table is the ability to draw a target and then check if constraints are met. Many of us take a far more active role in cancer management, counseling, coordination of care, etc.

 

[Mandelin Rain]

Many of us take a far more active role in cancer management, counseling, coordination of care, etc.

I pride myself in all of this. But I also understand that when push comes to shove, none of this pays the bills.

 

[medgator]

I pride myself in all of this. But I also understand that when push comes to shove, none of this pays the bills.

I have a fairly good relationship with my dermatology group, general surgeons, pulm, ents and a couple of GUs. I just don't see them all of a sudden sending to a med onc. Not sure how it will work in brave new payment world when a rad onc is the first oncology provider to see a pt?

Honestly half the time the MOs are asking me what the stage is when we co manage pts and usually I'm sending them pts for concurrent etc after the wu and staging is complete. Definitely the case in anal and h&n patients.

Part of making the specialty strong again is taking ownership of our patients from workup/staging to symptom management and beyond. Of course an attitude change won't save us from 200 grads/year coming out

 

[KHE88]

No more residents at satellites. If caseload can't support 100% of residents at the main site, reduce slots to what the main site can accommodate.

Solves multiple problems.

Something that surprised me: When I was a med student, rad onc was one of the most competitive specialties, up there with derm and ortho. I thought we'd be pretty well respected by colleagues and admin. Wrong. We are used as a cash cow (and don't see a lot of that back in our department) and treated like technicians. Med oncs and surgeons run the show. Admin will bend over backwards to keep a needed specialist surgeon happy. Rad onc? Those guys in the basement? Tell me again why we are paying them all that money "to just sit there" (favorite phrase)?

If you think a less favorable supply demand curve combined with the above isn't going to result in massive siphoning off of rad onc pro fees (they already took all of technical), you've got your head in the sand.

Oh, and don't apply to places like Mayo where leaders are gaslightning everyone about the problem.

 

[OTN]

No more residents at satellites. If caseload can't support 100% of residents at the main site, reduce slots to what the main site can accommodate.

Solves multiple problems.

Something that surprised me: When I was a med student, rad onc was one of the most competitive specialties, up there with derm and ortho. I thought we'd be pretty well respected by colleagues and admin. Wrong. We are used as a cash cow (and don't see a lot of that back in our department) and treated like technicians. Med oncs and surgeons run the show. Admin will bend over backwards to keep a needed specialist surgeon happy. Rad onc? Those guys in the basement? Tell me again why we are paying them all that money "to just sit there" (favorite phrase)?

If you think a less favorable supply demand curve combined with the above isn't going to result in massive siphoning off of rad onc pro fees (they already took all of technical), you've got your head in the sand.

Oh, and don't apply to places like Mayo where leaders are gaslightning everyone about the problem.

All practices are different, and I do feel respected at mine, have good conversations with referring docs and feel as if I'm an equal part of the care team.

You are 100% right, however, that increased supply of radonc grads is going to further exploitation in certain practice types (employed hospital practices and academic practices, naturally).

I agree with others who have posted here: It is unethical to try to convince medical students to go into radonc in its current state.

 

[RickyScott]

[/QUOTE[/QUOTE]

Something that surprised me: When I was a med student, rad onc was one of the most competitive specialties, up there with derm and ortho. I thought we'd be pretty well respected by colleagues and admin. Wrong. We are used as a cash cow (and don't see a lot of that back in our department) and treated like technicians. Med oncs and surgeons run the show. Admin will bend over backwards to keep a needed specialist surgeon happy. Rad onc? Those guys in the basement? Tell me again why we are paying them all that money "to just sit there" (favorite phrase)?

If you think a less favorable supply demand curve combined with the above isn't going to result in massive siphoning off of rad onc pro fees (they already took all of technical), you've got your head

This is so true regarding attitude of most administrations I have encountered. “We are the end of a process” is how it was put to me by a senior administrator.( the bar at the restaurant is where all the money is made, but the Chef is the star usually)
Siphoning off pro fees, is that what happened in path?

 

[OTN]

We shouldn't blame the administrators. They're acting as expected, by trying to increase profits by limiting labor costs. We should expect them to drive radonc salaries as low as they can, which can and will include siphoning off professional fees.

 

[scarbrtj]

Agreed. Also - we have professional societies for a reason. No way this would happen. Radiologists don’t know anything about cancer.

We have a niche and we own that niche. Doing this and doing it well (ie being good oncologists, owning our patients) was all fine until we started training 1.5-2x the number of practitioners that are needed to fill that niche.

200 trainees/yr wasn’t an absurd notion when everything was 30-40 fx, but any academic with any sense knew years ago breast was going to 15 and prostate to 20 (or 5...or 0). This should have given pause to the expansion and it didn’t. Now we’re trying to throw Hail Mary passes. Just fix the damn problem.

If I were a medical student today I’d ask every program I interviewed at “what are you doing to address the oversupply problem?” and refuse to rank any programs that don’t acknowledge it. The applicant pool this year has shrunk so drastically that it is a buyers market and programs will be desperate to appease anyone with a good app.

If they don’t care about your future after training, they definitely won’t care about you during training.

Malignant programs should go unmatched and receive immense and public pressure not to accept anyone in the SOAP who did not apply to radiation oncology or do a radiation oncology rotation. Anyone who takes some unmatched applicant who has no idea what the field is should be shamed loudly for not allowing the market to correct itself.

This is the Zietman Proposal: let medical students dictate labor supply. They are doing it and have shown us that around 140/yr is the current level of interest in this field. Programs should respect the market. Respect the Zietman Proposal.

Residency expansion is what is killing this speciality - not AI, not immunotherapy, not the APM, not radiologists magically learning to stage a cancer.

No more residents at satellites. If caseload can't support 100% of residents at the main site, reduce slots to what the main site can accommodate.

Solves multiple problems.

Something that surprised me: When I was a med student, rad onc was one of the most competitive specialties, up there with derm and ortho. I thought we'd be pretty well respected by colleagues and admin. Wrong. We are used as a cash cow (and don't see a lot of that back in our department) and treated like technicians. Med oncs and surgeons run the show. Admin will bend over backwards to keep a needed specialist surgeon happy. Rad onc? Those guys in the basement? Tell me again why we are paying them all that money "to just sit there" (favorite phrase)?

If you think a less favorable supply demand curve combined with the above isn't going to result in massive siphoning off of rad onc pro fees (they already took all of technical), you've got your head in the sand.

Oh, and don't apply to places like Mayo where leaders are gaslightning everyone about the problem.

What we need is a Jerry McGuire-type person and manifesto in rad onc that would deal primarily with the main problem: too many clients (aka residents). "The Things We Think And Do Not Say: The Future of Our Business." And then go on and try and fix the other problems, lack of intraspecialty, interspecialty, and administrational respect being pretty big.

 

[medgator]

Siphoning off pro fees, is that what happened in path?

Per the threads I've seen over there, yes. Lots of corporate and group takeovers where pathologists essentially were turned into technicians and their pro fees were skimmed by them, made possible, in part, by the oversupply

 

[CidHighwind]

Why can’t they just make radonc an “independent residency” or fellowship like they did with IR? From what I understand, you guys are already under ACR, so it shouldn’t be that difficult. Could decrease the time from 4 years to 3 (maybe 2) and would give rads people that “miss patient contact” a different option besides breast imaging. In addition, the increased training time and opportunity to decrease spots would fix the labor market. Or would that be too difficult?

 

[medgator]

Why can’t they just make radonc an “independent residency” like they did with IR?

We are an independent residency from radiology. Just like IR. It's been like that for decades in rad onc

 

[CidHighwind]

We are an independent residency from radiology. Just like IR. It's been like that for decades in rad onc

Meant to say fellowship.

 

[medgator]

Meant to say fellowship.

Probably have as much in common, if not more, with med onc. I think a combo med/rad onc fellowship without hematology would be great off internal.

Would hate having to do im residency, but it is most viable thing to do if someone were to try and reshape the way we are trained.

That being said, I do NOT think the above is truly necessary, but it is certainly something to think about.

Rad onc could be a great field again if we trim the number of spots back to 2006-2007 levels

 

[evilbooyaa]

I did... Isn’t he still considered a thought leader in our field?

While Chirag Shah may have rebounded his career nicely, the vitriol and response he received speaking out about his concerns in regards to residency expansion was quite depressing to see and likely lead to suppression of that thought process amongst anybody in the red journal. That response likely lead to a 5-year period where ASTRO just had their head in the sand (until it's finally starting to get some discussion now that it's affecting medical student entry into the field).

 

[Mandelin Rain]

My favorite part of the "bloodbath" was the Wash U (which at that point was Shah's employer) chairman openly admitting that they were increasing residency spots because the salaries paid to their physicians had gone up.

Direct quote from Hallahan response:

This shortage has, in part, resulted in an increase in salaries for radiation oncologists in academic programs, as demonstrated by the Association of American Medical Colleges faculty salary survey report (2). To address the growing need for radiation oncologists, Washington University (Mallinckrodt Institute of Radiology and Siteman Cancer Center) has applied for an increase in our number of residents. We are also actively collaborating with Saint Louis University to initiate a residency in radiation oncology.


Med students, you want to know what the impetus was for residency expansion? It's right there in black and white, from an academic chairman. It was to drive your future salary down and maximize profitability of academic departments. It's gross, but it's true.

 

[deleted1002574]

While Chirag Shah may have rebounded his career nicely, the vitriol and response he received speaking out about his concerns in regards to residency expansion was quite depressing to see and likely lead to suppression of that thought process amongst anybody in the red journal. That response likely lead to a 5-year period where ASTRO just had their head in the sand (until it's finally starting to get some discussion now that it's affecting medical student entry into the field).

I guess I just don't know what ostracized means.

 

[medgator]

My favorite part of the "bloodbath" was the Wash U (which at that point was Shah's employer) chairman openly admitting that they were increasing residency spots because the salaries paid to their physicians had gone up.

Direct quote from Hallahan response:

This shortage has, in part, resulted in an increase in salaries for radiation oncologists in academic programs, as demonstrated by the Association of American Medical Colleges faculty salary survey report (2). To address the growing need for radiation oncologists, Washington University (Mallinckrodt Institute of Radiology and Siteman Cancer Center) has applied for an increase in our number of residents. We are also actively collaborating with Saint Louis University to initiate a residency in radiation oncology.


Med students, you want to know what the impetus was for residency expansion? It's right there in black and white, from an academic chairman. It was to drive your future salary down and maximize profitability of academic departments. It's gross, but it's true.

Someone should throw that out to all the #radonc Twitter sheeple

 

[deleted941485]

My favorite part of the "bloodbath" was the Wash U (which at that point was Shah's employer) chairman openly admitting that they were increasing residency spots because the salaries paid to their physicians had gone up.

Direct quote from Hallahan response:

This shortage has, in part, resulted in an increase in salaries for radiation oncologists in academic programs, as demonstrated by the Association of American Medical Colleges faculty salary survey report (2). To address the growing need for radiation oncologists, Washington University (Mallinckrodt Institute of Radiology and Siteman Cancer Center) has applied for an increase in our number of residents. We are also actively collaborating with Saint Louis University to initiate a residency in radiation oncology.


Med students, you want to know what the impetus was for residency expansion? It's right there in black and white, from an academic chairman. It was to drive your future salary down and maximize profitability of academic departments. It's gross, but it's true.

If a statement like that doesn’t make you wish pestilence on him and his progeny I don’t know what will.

 

[deleted1002574]

If a statement like that doesn’t make you wish pestilence on him and his progeny I don’t know what will.

Pestilence!! Agree!!

 

[deleted941485]

Should be posted to every medical student before they apply to Rad Onc or any program what so ever...it’s not about your education at all.

 

[PleaseRemainCalm]

Why can’t they just make radonc an “independent residency” or fellowship like they did with IR? From what I understand, you guys are already under ACR, so it shouldn’t be that difficult. Could decrease the time from 4 years to 3 (maybe 2) and would give rads people that “miss patient contact” a different option besides breast imaging. In addition, the increased training time and opportunity to decrease spots would fix the labor market. Or would that be too difficult?

I don't think most of the people who are attracted to radiology would be interested im radiation oncology. Right now most of our nonpalliative patients are still coming in for at least 3 weeks of daily radiation with weekly patient visits. I cannot imagine most people who go into radiology dealing with very sick patients in clinic or patiently listening to all the questions a patient asks when they know their doctor is in the building every day.

 

[medgator]

I don't think most of the people who are attracted to radiology would be interested im radiation oncology. Right now most of our nonpalliative patients are still coming in for at least 3 weeks of daily radiation with weekly patient visits. I cannot imagine most people who go into radiology dealing with very sick patients in clinic or patiently listening to all the questions a patient asks when they know their doctor is in the building every day.

Personally, I can't imagine sitting at a pacs all day reading film either.

 

[scarbrtj]

Why can’t they just make radonc an “independent residency” or fellowship like they did with IR? From what I understand, you guys are already under ACR, so it shouldn’t be that difficult. Could decrease the time from 4 years to 3 (maybe 2) and would give rads people that “miss patient contact” a different option besides breast imaging. In addition, the increased training time and opportunity to decrease spots would fix the labor market. Or would that be too difficult?

Seems like some of us are forgetting the recent editorial from three of the biggest wigs in rad onc: Wallner, Hahn, and Zeitman.

"The title of this editorial is from Ruth I:16 (King James version of the Bible), and as with Ruth and Naomi, the disciplines of diagnostic radiology (DR) and radiation oncology (RO) were inexorably linked from their inceptions through the post–World War II era... True hybrid programs blending DR and RO training from the outset have also been proposed... As did Ruth and Naomi, we must once again walk together."

 

[xrthopeful]

I think multiple people have posted damn good reasons about why DR and RO aren’t really things to mix at all. Not really even close.

 

[Mandelin Rain]

Seems like some of us are forgetting the recent editorial from three of the biggest wigs in rad onc: Wallner, Hahn, and Zeitman.

"The title of this editorial is from Ruth I:16 (King James version of the Bible), and as with Ruth and Naomi, the disciplines of diagnostic radiology (DR) and radiation oncology (RO) were inexorably linked from their inceptions through the post–World War II era... True hybrid programs blending DR and RO training from the outset have also been proposed... As did Ruth and Naomi, we must once again walk together."

Bingo. It seems like a combined IR/RO residency has been discussed by Zeitman since I started training. I know people think it's crazy, but I don't. Unlikely, but not crazy.

If they can cryo/microwave/TACE tumors, my guess is they can trace them. And like I said, they own our boards and have killed a specialty before. Much larger pool of docs, bigger PAC, bigger voice, etc... etc... etc...

 

[PleaseRemainCalm]

Personally, I can't imagine sitting at a pacs all day reading film either.

Yes, for me, that would get old and sad rather quickly. Not that a rad onc wouldn't be very easily trained to do that and vice versa, just that it's not a good personality/lifestyle match.

 

[scarbrtj]

I think multiple people have posted damn good reasons about why DR and RO aren’t really things to mix at all. Not really even close.

Probably not. On the other hand, when faced with a rad onc existential crisis, some of the "top people" came up with this as the solution. And put it out there pretty prominently.

 

[deleted941485]

Probably not. On the other hand, when faced with a rad onc existential crisis, some of the "top people" came up with this as the solution. And put it out there pretty prominently.

And like most of their ideas, it’s just as disappointing as ever.

 

[RickyScott]

Seems like some of us are forgetting the recent editorial from three of the biggest wigs in rad onc: Wallner, Hahn, and Zeitman.

"The title of this editorial is from Ruth I:16 (King James version of the Bible), and as with Ruth and Naomi, the disciplines of diagnostic radiology (DR) and radiation oncology (RO) were inexorably linked from their inceptions through the post–World War II era... True hybrid programs blending DR and RO training from the outset have also been proposed... As did Ruth and Naomi, we must once again walk together."

Did confirm that Hahn, soon to be nations most prominent radonc is boarded in medonc. While politically, may be difficult in the us, clinical oncology radonc/medonc has proven track record across Atlantic. Makes so much more sense than interventional oncology. Several former chairs who were boarded in both.

 

[Mandelin Rain]

Reading the editorial, it basically states that graduating rad oncs aren't radiology enough to practice modern radiation oncology, That they have to get much more radiology-y. That radiology should be tested more on the radiation oncology boards by the board that certifies radiologists.

I mean, laugh all you want. Strikes me as a pretty clear shot across the bow.

 

[Mandelin Rain]

Between the punitive contract outs, an academic chairman publicly endorsing wage fixing through overtraining, and prominent leaders in our field pushing us to the arms of the always hungry radiologists, I've seen a few good reasons to be wary of this field from a medical student perspective posted here in the past 12 hours.

 

[deleted941485]

Reading the editorial, it basically states that graduating rad oncs aren't radiology enough to practice modern radiation oncology, That they have to get much more radiology-y. That radiology should be tested more on the radiation oncology boards by the board that certifies radiologists.

I mean, laugh all you want. Strikes me as a pretty clear shot across the bow.

Very true and it may be right. May be something that can be used to shut a few programs down somehow someway not really sure.

I’m still very much interested in getting something like a Med Onc marriage going. Idk how that would work but it would st least be exploring. We adopt so much of the work they do in Europe and really I don’t see why the non surgical aspect of oncology should continue to operate in silos anymore.

 

[RickyScott]

Reading the editorial, it basically states that graduating rad oncs aren't radiology enough to practice modern radiation oncology, That they have to get much more radiology-y. That radiology should be tested more on the radiation oncology boards by the board that certifies radiologists.

I mean, laugh all you want. Strikes me as a pretty clear shot across the bow.

FYI-prior editorial by zeitman compared radonc to specialty treating syphilis, which faded away with antibiotics.

 

[Mandelin Rain]

FYI-prior editorial by zeitman compared radonc to specialty treating syphilis, which faded away with antibiotics.

I remember that one. Yowza.

 

[PleaseRemainCalm]

Did confirm that Hahn, soon to be nations most prominent radonc is boarded in medonc. While politically, may be difficult in the us, clinical oncology radonc/medonc has proven track record across Atlantic. Makes so much more sense than interventional oncology. Several former chairs who were boarded in both.

Several people in academics in his age cohort did a full IM residency and med onc fellowship before coming to rad onc. Other names escape me right now. But I very much doubt that they are as on top of the systemic literature as their pure med onc colleagues--in other words it is not like they are actually practicing modern medical oncology.

 

[CidHighwind]

I don't think most of the people who are attracted to radiology would be interested im radiation oncology. Right now most of our nonpalliative patients are still coming in for at least 3 weeks of daily radiation with weekly patient visits. I cannot imagine most people who go into radiology dealing with very sick patients in clinic or patiently listening to all the questions a patient asks when they know their doctor is in the building every day.

A lot of people sure, but there are some that don’t mind talking to patients, and one could argue that one shouldn’t do IR if you don’t like DR, but people unfortunately apply DR just to do IR.

 

[Kuratz]

This “radiologists doing rad onc” literally just got pulled out of thin air. Radiologists don’t freaking want to do Rad Onc or vice versa. Any change to the paradigm wouldn’t be driven by practicing clinicians but rather the chin-stroking academicians who are currently torpedoing your field.

 

[deleted941485]

FYI-prior editorial by zeitman compared radonc to specialty treating syphilis, which faded away with antibiotics.

Yup...and I’ll bet it didn’t take 4 years to learn how to treat syphillis in the pre abx days either. Probably just moved onto treating BP and diabetes like everyone else.

 

[scarbrtj]

Several former chairs who were boarded in both.

Charles Thomas at OHSU
Andrew Turrisi MUSC, Wayne State, now at Johnson City vet admin hosp

FYI-prior editorial by zeitman compared radonc to specialty treating syphilis, which faded away with antibiotics.

Aside: 'Dr. Ehrlich's Magic Bullet' is one of the best medical movies ever made. Cure of syphilis is the forefather of today's targeted anti-cancer drugs. Carry on.

 

[RickyScott]

Several people in academics in his age cohort did a full IM residency and med onc fellowship before coming to rad onc. Other names escape me right now. But I very much doubt that they are as on top of the systemic literature as their pure med onc colleagues--in other words it is not like they are actually practicing modern medical oncology.

I know, including the dean of univ of michigan, alan lichter who was ceo/president of ASCO.. In the clinical oncology model in UK as I understand it, clinical oncs are not giving 4th line myeloma or melanoma treatments but just basic stuff which is probably 80% of solid tumor malignancy treatments. I agree the diagnostic radiology stuff was pulled out of thin air. Almost all those dual trained came from NCI, where they did radonc, research, and would literally have 5 pts or less per attending.
This is totally speculative, but it would not surprise me if those who wrote this editorial are really weak in cross sectional body imaging (they all had predominantly research and administrative pursuits since before the CT sim became commonplace) , but recognize its importance, and think everyone else needs training in it as well. If nothing else, the editorial opens up the possibility that at the highest level, very smart people, like Zeitman, know that the current situation is totally unsustainable- another rebuke to the twitter crowd.

 

[thecarbonionangle]

FYI-prior editorial by zeitman compared radonc to specialty treating syphilis, which faded away with antibiotics.

Maybe with things like the abx resistant clap on the rise, we could pick this up as a back up.

Zeitman spoke of canaries. When canary died and we got the black lung, he remained silent, too busy rubberstamping surveys into the red journal. Keep hoping for a white knight!

 

[Mandelin Rain]

the abx resistant clap

Hard pass.

 

[RadOncDoc21]

I know, including the dean of univ of michigan, alan lichter who was ceo/president of ASCO.. In the clinical oncology model in UK as I understand it, clinical oncs are not giving 4th line myeloma or melanoma treatments but just basic stuff which is probably 80% of solid tumor malignancy treatments. I agree the diagnostic radiology stuff was pulled out of thin air. Almost all those dual trained came from NCI, where they did radonc, research, and would literally have 5 pts or less per attending.
This is totally speculative, but it would not surprise me if those who wrote this editorial are really weak in cross sectional body imaging (they all had predominantly research and administrative pursuits since before the CT sim became commonplace) , but recognize its importance, and think everyone else needs training in it as well. If nothing else, the editorial opens up the possibility that at the highest level, very smart people, like Zeitman, know that the current situation is totally unsustainable- another rebuke to the twitter crowd.

When I came out, I had a doc who I was working with who wasn’t familiar with SBRT and could not understand how I could give high doses in 3-5 fractions to the lung. They felt that “we” needed special training to provide “experimental” care. Needless to say, I left that group but it was a challenge trying to get them to “see” things differently as they “knew” everything there was need to know about radiation oncology already. I guess this is better than the guy doing SBRT without knowing much about it which I’ve also come across.

 

[FindMeOnTheLinks]

Charles Thomas at OHSU
Andrew Turrisi MUSC, Wayne State, now at Johnson City vet admin hosp

Ted Lawrence at UM as well

 

[evilbooyaa]

When I came out, I had a doc who I was working with who wasn’t familiar with SBRT and could not understand how I could give high doses in 3-5 fractions to the lung. They felt that “we” needed special training to provide “experimental” care. Needless to say, I left that group but it was a challenge trying to get them to “see” things differently as they “knew” everything there was need to know about radiation oncology already. I guess this is better than the guy doing SBRT without knowing much about it which I’ve also come across.

If you are more than 10 years out from residency and are not well read, I will know more about contemporary radiation oncology (like how to actually treat patients walking in through the door) than you at the current time.

Those who do not learn from those more junior to them and remain rooted in the "this is how things have always been done" are relics of the field.

 

[deleted941485]

If you are more than 10 years out from residency and are not well read, I will know more about contemporary radiation oncology (like how to actually treat patients walking in through the door) than you at the current time.

Those who do not learn from those more junior to them and remain rooted in the "this is how things have always been done" are relics of the field.

And they’ll never retire no matter how much they saved. Self serving greedy bottom feeders to the bitter end.

 

[medgator]

And they’ll never retire no matter how much they saved. Self serving greedy bottom feeders to the bitter end.

The Worst Generation

Or, how I learned to stop worrying and hate the Boomers.

www.esquire.com

 

[deleted956486]

After the Match: Is There an EM Residency Glut? : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

What a real editorial looks like. Compare that to the PW/LK nonsense the red journal is spitting out.


Older academics are glutting radiation oncology.