medstudents entering the match

[taserlaser]

Have to give their society kudos for releasing that spring statement. Thats the kind of leadership our field is lacking.

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.

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Members don't see this ad.

 

[xrthopeful]

 

[Neuronix]

In EM it's easy for the academics to point their fingers at private hospital systems opening and expanding residencies.

In rad onc the problem is academics opening and expanding residencies. Are academic rad oncs willing to point the finger at themselves for residency overexpansion?

 

[xrthopeful]

I think the corporatization of medicine plays a key role in both in different ways.

Step 1: a hospital buys out a smaller hospital/practice
step 2: that smaller rad onc department becomes part of the main department. Either they start staffing the site with their own people or they kill
Their practice, thus driving more people to the main site.
Step 3: either one causes more ‘academic hirings’ and less ‘PP hirings’
Step 4: all of a sudden there are more people at the main site, and we are seeing more patients in our enterprise than ever, why not expand?


When steps 1-4 happen over the course of the last 15 years, ad nauseum, at lots of places, that’s how you end up with too many training spots

 

[Mandelin Rain]

And Lord knows every academic attending needs a PA, I mean... resident, to "slow them down."

 

[RickyScott]

I think the corporatization of medicine plays a key role in both in different ways.

Step 1: a hospital buys out a smaller hospital/practice
step 2: that smaller rad onc department becomes part of the main department. Either they start staffing the site with their own people or they kill
Their practice, thus driving more people to the main site.
Step 3: either one causes more ‘academic hirings’ and less ‘PP hirings’
Step 4: all of a sudden there are more people at the main site, and we are seeing more patients in our enterprise than ever, why not expand?


When steps 1-4 happen over the course of the last 15 years, ad nauseum, at lots of places, that’s how you end up with too many training spots

Radiation is more adversely affected than other specialties. Because of the technical profit in radiation, the expansion of radiation services/satellites outpaces that of the system as whole. Obviously, the systems are going to preferentially emphasize expansion of their profitable service lines. (again, why I argue lower technical reimbursements is in the interests of most radoncs) Upenn is a great example of this, as it now probably has the most patients on beam in north america. They certainly didnt expand their outpatient psych or obgyn into neighboring areas to the extent they did with radonc.

 

[xrthopeful]

upmc has got to be up there too.

 

[redalert]

upmc has got to be up there too.

If I remember correctly UPMC only has 2 spots. I thought that was a fairly small class for such a big hospital system. Did they recently expand from 1 to 2?

 

[RickyScott]

If I remember correctly UPMC only has 2 spots. I thought that was a fairly small class for such a big hospital system. Did they recently expand from 1 to 2?

Around 12 years ago UPMC did not even have a residency!

 

[deleted956486]

And Lord knows every academic attending needs a PA, I mean... resident, to "slow them down."

Was that Beaumont? Statements like that are really just an embarrassment and reflective of the level of intelligence required to get into RO during that era. As much as the response to Shah's editorial made people angry, at least they were honest about it.

 

[medgator]

If I remember correctly UPMC only has 2 spots. I thought that was a fairly small class for such a big hospital system. Did they recently expand from 1 to 2?

I think he was referring to the size of UPMC cancer network. they've been expanding like crazy since the turn of the century

Patients Caught In Middle Of Fight Between Health Care Behemoths - KFF Health News

A legal battle in Pennsylvania is testing the boundaries of health care competition and government action to oversee and regulate it.

khn.org

 

[xrthopeful]

I think he was referring to the size of UPMC cancer network. they've been expanding like crazy since the turn of the century

Patients Caught In Middle Of Fight Between Health Care Behemoths - KFF Health News

A legal battle in Pennsylvania is testing the boundaries of health care competition and government action to oversee and regulate it.

khn.org

Yes

 

[RickyScott]

"How will it feel for them to pay back $250,000 while huge, highly profitable health care organizations increase their bottom line by slowly nibbling away at their paycheck?" -Is There an EM Residency Glut

Almost as bad as it feels to be paying back $250,000 while well-paid chairs at highly profitable academic institutions alternately vilify and ignore you from on high for calling them out on their self-serving labor market machinations.

The irony is that a suppression of radiation oncology salaries is unlikely to yield any cost savings to patients, health insurance organizations, or society.

Chairs, some of whom sold practices to 21C for probably over 10 million like michael steinberg, are generally tasked with managing salaries of docs. So while salary reductions meaningless to health care savings, they mean a lot in the little silo world of the chair (hence residency expansion for cheap labor) where managing salaries is one of their primary responsibilities. Was he also part of that group of SoCal docs that founded Vantage that was bought by us health/mckesson for 1.2 billion. ?

"Last year he (dosoretz) bought a radiation center in Santa Monica, Calif. run by Michael Steinberg, a member of an influential trade group that advises Medicare on how to set rates for the latest technologies."

 

[medgator]

Was he also part of that group of SoCal docs that founded Vantage that was bought by us health/mckesson for 1.2 billion. ?

Nope. Doseretz wasn't part of that.

 

[medgator]

Was Steinberg? I thought Valley/vantage bought some of his centers and brought him on board as well, but I am not on that coast so really not sure.

Don't think so.

VANTAGE ONCOLOGY ANNOUNCES JOINT VENTURE WITH VALLEY RADIOTHERAPY ASSOCIATES MEDICAL GROUP TO FORM CENTER FOR RADIATION THERAPY

www.dotmed.com

 

[nkmiami]

Don't think so.

VANTAGE ONCOLOGY ANNOUNCES JOINT VENTURE WITH VALLEY RADIOTHERAPY ASSOCIATES MEDICAL GROUP TO FORM CENTER FOR RADIATION THERAPY

www.dotmed.com

Valley docs are the ones who founded Vantage? I just dont hear about them much, but I know they rivaled 21 C in scope.

 

[medgator]

Valley docs are the ones who founded Vantage? I just dont hear about them much, but I know they rivaled 21 C in scope.

Yes. DD wasn't involved. Chris Rose was. Vantage >>> 21C in terms of managing their practices and finances.

 

[RickyScott]

Yes. DD wasn't involved. Chris Rose was. Vantage >>> 21C in terms of managing their practices and finances.

Good form him My interaction with Chris Rose as medstudent were very positive. He was very supportive.

 

[OTN]

Chris Rose is one of the greatest leaders in radiation oncology we have and very, very supportive of all types of docs.

 

[deleted956486]

Tbh I'm surprised anyone is still applying to RO.

 

[deleted956486]

If I were applying now, I’d rank only the top 10 programs. Anything below that and you’ll be throwing your MD away IMO. There’ll probably be room for about 50 good jobs per year even 5-6 years from now.

Beyond that and you’re gambling with your future.

I dont think that's true. Your negotiating power ultimately goes down no matter what program. I mean the guys at MD anderson, harvard and MSK are slowly lowering their standards in terms of jobs if you look at their outcomes.

 

[medgator]

If I were applying now, I’d rank only the top 10 programs. Anything below that and you’ll be throwing your MD away IMO. There’ll probably be room for about 50 good jobs per year even 5-6 years from now.

Beyond that and you’re gambling with your future.

Even that's not a guarantee. I'd only apply to rad onc if I truly loved it and would be fine settling my family down in bustling metropolises like Rhinelander, Quincy, Elko, Salina, El Centro etc

 

[deleted941485]

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.

Bravo. Now actually do something about it. We know what the plan is for these Corp practices. Now it’s time to disrupt the **** out of them. Shame the people doing it. Make them work to prove they are truly looking to educate rather than saturate the field of underpaid lemmings. Make them spend as much money on these programs as they think they’ll get out of it in the long term. It’s all downhill from here.

 

[deleted956486]

Even that's not a guarantee. I'd only apply to rad onc if I truly loved it and would be fine settling my family down in bustling metropolises like Rhinelander, Quincy, Elko, Salina, El Centro etc

Tbh, I'd be surprised if these last.

 

[RadOncMegatron]

Oh I don’t think it’s a guarantee at all, but I think doing radonc today at a top 10-15 program is still a halfway decent option all things considered. At least moreso than one of these bottom of the barrel places.

I’m talking mainly to the people who still think radonc is a good option and plan on entering the match this year. I’d advise them to rank and interview only top programs and have a backup specialty if they don’t match there.

This sounds right. I hope med students understand that the actual field of radiation oncology is awesome. The patients, biology, and technology cannot be beat. If you happen to make it to a top 10-15 program you will most likely be ok. Beware if you can only make it to mid or low tier program. Really understand the market and understand you are NOT a big fish in the oncology system let alone medical system. Don't get me wrong, wherever you get in, my experience has been very cordial with my colleagues, but you are no ENT, urologist, or neurosurgeon. You are not Wally Curran, Cliff Robinson, Albert Koong, Zeitman, Amdur, etc. And if I am hiring you, I don't care where you are from, you better have someone I know vouch hard for you.

High risk / High reward. I am extremely blessed where I am, but am scared what I would have to do if I lose this job. The options are NOT GOOD. I am staying put.

 

[deleted941485]

Why would medical students want to slug out 5 years doing this and have little to show for it? Why risk it. Plenty of lower risk and high reward specialties outthere that people will actually hire you to perform without regurgitating endless nonsense and forcing you to work 2 hours away from civilization.

 

[medgator]

High risk / High reward. I am extremely blessed where I am, but am scared what I would have to do if I lose this job. The options are NOT GOOD. I am staying put.

Ditto. I'm done. Can't leave even if I wanted to. Lateraling to a new, equivalent job no longer exists in this field

 

[RadOncDoc21]

Ditto. I'm done. Can't leave even if I wanted to. Lateraling to a new, equivalent job no longer exists in this field

Agree! I rolled the dice a few times and landed a great opportunity but I definitely had to hustle and been through a lot to get to where I am. I know I’m very fortunate but there is no way in hell I’ll take another gamble!

 

[deleted941485]

Ditto. I'm done. Can't leave even if I wanted to. Lateraling to a new, equivalent job no longer exists in this field

At some point the opportunity costs should get to a point where your better off re training. I mean you could make 300K but then how do you put a dollar value on flexibility?

 

[RickyScott]

I dont think that's true. Your negotiating power ultimately goes down no matter what program. I mean the guys at MD anderson, harvard and MSK are slowly lowering their standards in terms of jobs if you look at their outcomes.

And after the first job, the "prestige" of the where you did residency becomes less and less important. And most of us change jobs at some point. A bad job market hurts everyone including those from top programs. Many will be frozen into jobs that in years past it was common to lateral out of.

 

[medgator]

At some point the opportunity costs should get to a point where your better off re training. I mean you could make 300K but then how do you put a dollar value on flexibility?

It's a good point. I think the question is about what you can live with. I got 2/3 and I'm thrilled with that, considering that was what the expectation was for a job when I entered the field and when I got out.

Getting 2/3 seems like a unicorn these days though and I don't seem to be the only one on this forum who is happy enough to just get what I get and not throw a fit. Retraining is a lot easier when you don't already have a family with kids in school, working spouse etc.

The bottom line is, I think there has always been a "lottery" component to getting a decent job in this field and with residency expansion and hypofx/APM, the odds have simply gotten ****tier as time goes on. You can certainly help those odds with techniques that Sheldor alluded to in the other thread, but it's still a lottery at the end of the day

 

[scarbrtj]

This sounds right. I hope med students understand that the actual field of radiation oncology is awesome. The patients, biology, and technology cannot be beat.

Hear, hear. On the other hand... I have seen many changes in my somewhat medium length career in rad onc.
1) Patient-doctor contact has decreased ~40-50% in the last decade.
2) The "biology" is mushrooming incredibly and it's an open question how much of it (re: cancer biology) we must/should know. Lee himself recently said as much although I don't think it was necessarily his intention:
"The primary role of a radiation oncology residency program is to train clinicians, not cancer biology graduate students... Given the importance of emotional intelligence (EI) and its association with better doctors, perhaps we should spend more time teaching our residents how to develop and build their own EI rather than learning every molecular pathway."
3) The technology is pretty great. When the insurance companies allow you to use it!

 

[deleted956486]

For medstudents entering the match, just remember the whole world is unhappy. That's the mantra in radiation oncology. Keep that in mind...

 

[FrostyHammer]

If you guys strongly believe that what she said is wrong, or have beef with it, why don't you reply to her tweets and have a constructive discussion with her instead of going back and ranting about it in an anonymous forum? Doing so will increase your credibility in the eyes of med students reading this...Just a thought, no judgment rendered either way.

 

[cujust]

Guys - please don't take my post out of context. I was referring to the increasing significant physician dissatisfaction about their jobs across specialties, not just rad onc. Physician burnout and loss of autonomy etc etc... you know what I was talking about. The whole world is indeed unhappy (look at the current political landscape). So we cannot judge the specialty based on a single cross-sectional survey - we need to look at trends and also need reference points. However, I do believe that rad onc physicians are still much happier compared to many other medical fields. In any case, I do want to clarify my points and welcome any constructive feedback.
Jillian Tsai
@CJTsaiMDPhD
PS. This is the account I registered during med school and had not been using it for a long time... until I was attacked. But I stand behind my statements and would love to chat with any med student interested in rad onc. Feel free to contact me.

 

[medgator]

Guys - please don't take my post out of context. I was referring to the increasing significant physician dissatisfaction about their jobs across specialties, not just rad onc. Physician burnout and loss of autonomy etc etc... you know what I was talking about. The whole world is indeed unhappy (look at the current political landscape). So we cannot judge the specialty based on a single cross-sectional survey - we need to look at trends and also need reference points. However, I do believe that rad onc physicians are still much happier compared to many other medical fields. In any case, I do want to clarify my points and welcome any constructive feedback.
Jillian Tsai
@CJTsaiMDPhD
PS. This is the account I registered during med school and had not been using it for a long time... until I was attacked. But I stand behind my statements and would love to chat with any med student interested in rad onc. Feel free to contact me.

It is compounded in rad onc when your job prospects go from bad to worse, in part, thanks to residency expansion.

Ask all those recent grads taking fellowships that didn't exist a decade ago and still aren't recognized by the acgme.

 

[deleted956486]

Guys - please don't take my post out of context. I was referring to the increasing significant physician dissatisfaction about their jobs across specialties, not just rad onc. Physician burnout and loss of autonomy etc etc... you know what I was talking about. The whole world is indeed unhappy (look at the current political landscape). So we cannot judge the specialty based on a single cross-sectional survey - we need to look at trends and also need reference points. However, I do believe that rad onc physicians are still much happier compared to many other medical fields. In any case, I do want to clarify my points and welcome any constructive feedback.
Jillian Tsai
@CJTsaiMDPhD
PS. This is the account I registered during med school and had not been using it for a long time... until I was attacked. But I stand behind my statements and would love to chat with any med student interested in rad onc. Feel free to contact me.

You weren't "attacked." You made a dumb comment and people responded. Why is it that many in academia are always quick to cry foul at the slightest disturbance (LK cyberbullied lol), meanwhile they are more than willing to hurt others without a tinge of guilt (ask your chair how he felt about failing all those residents)? Maybe you should get out of your bubble and see other perspectives? Maybe not everyone is where you are? Maybe of all people, doctors should be able to do that?

You're attempting to diminish the problems in radiation oncology in 2 ways. The first argument you make is that current evidence is flawed because it is not presented in the context of all "medical specialties." So, now that the evidence is there, it's not enough? Let me guess, you need a RCT? I'm sorry, your chair will have to hire an NP for a few years. Don't like it? Quit. You can probably afford to-not everyone has that luxury.

The second argument you posit is that the world is unhappy, and therefore the sentiments among the junior radiation oncologists and residents should be examined in the context of a bleak worldview. The world isn't "unhappy," (maybe the world of MSK is unhappy?) and just because there is civil unrest in Venezeula, or poverty on the subway, it doesn't justify what academic leadership is doing to residents and younger radiation oncologists.

"Suck it up, babies in Africa have no food." While that may be true, it's not germane to a medical student making a lifelong career decision. People are fed up with that guilting garbage-it ain't gonna work, sorry.

 

[cujust]

Hi all - all of your points are well taken. I think a lot of what we said on the internet can easily be misconstrued. But please we all need to unify and work together in order to continue improving this field - we have much more in common than not.
In any case, for medical students exploring the possibility of rad onc and work/family/life balance, I'm happy to chat.
Jillian Tsai
@CJTsaiMDPhD
[email protected]

 

[deleted774703]

Hi all - all of your points are well taken. I think a lot of what we said on the internet can easily be misconstrued. But please we all need to unify and work together in order to continue improving this field - we have much more in common than not.
In any case, for medical students exploring the possibility of rad onc and work/family/life balance, I'm happy to chat.
Jillian Tsai
@CJTsaiMDPhD
[email protected]

Thanks for sharing your perspective. Agree with you that ppl in medicine overall are more unhappy.

One issue I’ve noted is that ppl in academics seem to use survey data for their convenience.

If survey looks good, then no problem with job market.

If survey looks bad, oh it’s just one survey and we need more data.

Can’t have it both ways. Please don’t be one of the ppl who does this.

It only adds fuel to the fire of the academic vs non-academic divide.

 

[deleted956486]

Hi all - all of your points are well taken. I think a lot of what we said on the internet can easily be misconstrued. But please we all need to unify and work together in order to continue improving this field - we have much more in common than not.
In any case, for medical students exploring the possibility of rad onc and work/family/life balance, I'm happy to chat.
Jillian Tsai
@CJTsaiMDPhD
[email protected]

It would be great if we could work together, however there is a power differential that favors academics. There is also a culture of elitism and passive-aggressive attitudes that are far too pervasive in radiation oncology. Not only is this culture unconducive to success in healthcare, it opens the door to corruption, discrimination and nepotism. This has been going on for a while and now the chickens are coming home to roost.

As an institution, MSK lacks transparency in so many ways and is hurting healthcare. I'm not going to even begin discussing this:

Independent Review Shows Memorial Sloan Kettering Leaders Repeatedly Violated Conflict of Interest Policies | BioSpace

A review of top officials at Memorial Sloan Kettering Cancer Center found that there were repeated violations on financial conflicts of interest. The review was conducted by law firm Debevoise & Plimpton and jointly reported by The New York Times and ProPublica.

www.biospace.com

The proton facility it just built will do nothing to improve the lives of the people of the city, and will cost an exorbitant amount of money. Keep in mind, MSK is a PPM exempt cancer institute:

Comparison of PPS-Exempt Hospitals, NCI-Designated Hospitals, and Other Hospitals That Provide Cancer Care

This cohort study compares the characteristics and postoperative outcomes of hospitals affiliated with Prospective Payment System (PPS)-exempt cancer centers, other hospitals affiliated with National Cancer Institute (NCI)-designated cancer centers, and other hospitals that provide cancer care in...

jamanetwork.com

This exemption status by MSK and many other institutions is being abused to enrich a few. These institutions are immune from value based care and continue to glutt the field by overtraining, thereby eliminating competition in the city. First-class healthcare will eventually become a luxury in the city. A procedure which costs 10k to deliver at a private practice, costs 100k at MSK. Why dont you ask your billing department what it charges for SRS, then call your nearest PP group and ask them what they charge?

Since we are talking about the whole world being unhappy, ask yourself how much you're contributing to that, whether that needs to be the case, and whether you're being used as a tool to make life harder and more expensive for others. Then, you can tell me about being "attacked."

 

[FrostyHammer]

Guys - please don't take my post out of context. I was referring to the increasing significant physician dissatisfaction about their jobs across specialties, not just rad onc. Physician burnout and loss of autonomy etc etc... you know what I was talking about. The whole world is indeed unhappy (look at the current political landscape). So we cannot judge the specialty based on a single cross-sectional survey - we need to look at trends and also need reference points. However, I do believe that rad onc physicians are still much happier compared to many other medical fields. In any case, I do want to clarify my points and welcome any constructive feedback.
Jillian Tsai
@CJTsaiMDPhD
PS. This is the account I registered during med school and had not been using it for a long time... until I was attacked. But I stand behind my statements and would love to chat with any med student interested in rad onc. Feel free to contact me.

Thank you Jillian for coming onto SDN openly and clearly, unlike most people in this forum who hurl their thoughts when hiding behind their screens (myself included). Not throwing anyone under the bus, but people, you got your direct discussion now.

 

[mdwithab]

To the med students out there considering RadOnc, I would urge you to talk to as many graduating residents and junior attendings as you can - directly, ideally on the phone or in person so you can paint a clearer picture of what’s going on in the field (ARRO publishes a resident directory if you’re looking for contacts - we’d be happy to talk with you, and feel free to DM me). And always remember that what you read on both SDN and Twitter about the RadOnc field/job outlook etc represents the vocal opinions of about a dozen people each.

 

[Haybrant]

The Baselga situation at MSK is among the most embarrassing situations in the history of academic medicine. I realize it has nothing to do with Dr Tsai but we should not forget the role that the institution played in degrading what hard working academicians have tried to accomplish. The world is getting harder right, but it was getting a whole lot easier and wealthier for Baselga and MSK. I would bet anything this was swept under the rug and is not spoken about there at all.

Edit: I will say I don’t blame academicians that don’t get it; they’re about 2-3 years behind what we know and understand here. They’ve only been part of the conversation for 4-6 months. Many of us have been here talking about these issues for 3-4 years. Its part of the academic hubris to see them jump in as if they have the answers and know all. I work w many similar people. My advice to them is to listen instead of talk right now.

 

[RadOncMegatron]

Hi all - all of your points are well taken. I think a lot of what we said on the internet can easily be misconstrued. But please we all need to unify and work together in order to continue improving this field - we have much more in common than not.
In any case, for medical students exploring the possibility of rad onc and work/family/life balance, I'm happy to chat.
Jillian Tsai
@CJTsaiMDPhD
[email protected]

Dr. Tsai, respect to you for coming on here to defend yourself. Needless to say you bought some cred. I thought you were fair in your discussion today on Twitter.

You must understand the divide that stands between you, a MD PhD at MSKCC, and everyone else. I ask you to bridge that gap (like coming onto SDN).

MSKCC (MDACC, Harvard, etc), as one of the top places need not worry itself with what is going on, quite frankly, as it should accept and train the best rad oncs, b/c that's what is needed from your elite institution. NOTHING WRONG WITH THAT!

BUT, we here at SDN are not convinced that the plight of the mid-to-low tier rad oncs is something you are aware of by no fault of your own. You are talented and far away from these problems.

One thing that strikes med students here probably is the that some of your colleagues at elite institutions show little understanding of the overall situation of the field. Again not your fault, but how much would MD/PhD director of H&N Rad Onc at MSKCC understand their plight? I'm sure you have some idea, but you need to show med students with comments here showing understanding or defending your point of view.

We have the uncomfortable feeling when attendings at MDACC or MSKCC are asking for private chats for prospective residency spots, only med students who have a chance getting into your programs will talk with you! These are not the ones worried about their future in rad onc.

TL;DR --> Talk to the med student applying to mid-low tier programs. They have spoken by not applying so it's your turn to convince them!

 

[Telorad]

To the med students out there considering RadOnc, I would urge you to talk to as many graduating residents and junior attendings as you can - directly, ideally on the phone or in person so you can paint a clearer picture of what’s going on in the field (ARRO publishes a resident directory if you’re looking for contacts - we’d be happy to talk with you, and feel free to DM me). And always remember that what you read on both SDN and Twitter about the RadOnc field/job outlook etc represents the vocal opinions of about a dozen people each.

Couldn't agree with this more. Feel free to DM as well.

This is straight up pathetic that some of you feel it is okay to target attendings and screenshot their twitter accounts- are you serious? Whats wrong with this field is people like you.

Yes, the job market is an issue which needs to be addressed. Yes, certain leaders of the field have made questionable decisions in the past regarding expansion of programs and yes, we need to have open discussions moving forward about how to rectify this. No one is denying that.

That does not make it okay for you all, hiding behind a veil of anonymity, to personally attack and call out individuals who seem to have an opinion that is different than yours. Seriously, if I am a prospective medical student and I'm reading this forum I would be turned off to the specialty just knowing that my so-called future/current "colleagues" think it is okay to do this. There is nothing further from medical professionalism than behaviors such as this. Obsessing over twitter accounts and feeling the need to post snarky remarks to make yourself feel better is so tacky, and pitiful. grow up.

 

[deleted956486]

Couldn't agree with this more. Feel free to DM as well.

This is straight up pathetic that some of you feel it is okay to target attendings and screenshot their twitter accounts- are you serious? Whats wrong with this field is people like you.

Yes, the job market is an issue which needs to be addressed. Yes, certain leaders of the field have made questionable decisions in the past regarding expansion of programs and yes, we need to have open discussions moving forward about how to rectify this. No one is denying that.

That does not make it okay for you all, hiding behind a veil of anonymity, to personally attack and call out individuals who seem to have an opinion that is different than yours. Seriously, if I am a prospective medical student and I'm reading this forum I would be turned off to the specialty just knowing that my so-called future/current "colleagues" think it is okay to do this. There is nothing further from medical professionalism than behaviors such as this. Obsessing over twitter accounts and feeling the need to post snarky remarks to make yourself feel better is so tacky, and pitiful. grow up.

It isn't a screenshot, it's called a link. Those are public comments open to discussion. Welcome to the real world. Sorry if you can't handle it, but don't turn yourself into a victim by claiming to be "attacked," and "targeted." It is unbecoming and diminishes so many things, especially coming from a physician. Again, this all comes back to the entitlement that is so rampant in radiation oncology. People are discussing misleading comments that were posted on a public media network-don't get it twisted.

Again, that elitism of radiation oncology can only go so far in the real world. I'm not your cleaning lady, your doorman, your dosimetrist and I'm definitely not your resident. Stop trying to confuse or mislead medical students-these are people that have real-life problems they need sorted out. Geography is important. People have spouses, children, elderly parents, etc. I'm sorry your satellites won't be staffed, but that's not what a career is about.

It's not your institution, and it's not an ASTRO workforce forum. If you say something misleading, people will discuss it, and they will call you out on it. Sorry if it's "tacky," or if you were tainted. If you want to fix these problems, you have to be willing to listen and get tainted.

 

[medgator]

Couldn't agree with this more. Feel free to DM as well.

This is straight up pathetic that some of you feel it is okay to target attendings and screenshot their twitter accounts- are you serious? Whats wrong with this field is people like you.

The focus has been on their message. Dr Tsai's initial comments came across as being completely out of touch to the specialty as a whole. Med students don't need to "discover" our specialty. We used to attract the best and brightest a decade ago and now we can't even fill with US grads.

And quite frankly she isn't the only one guilty of this, sadly. This is isn't about her, rather it's been about her message. Pretty much anyone who's been insulated/ignorant in academics the last several years while this problem compounded, got a huge wakeup call along with ASTRO in March 2019.

Haybrant nailed it above. Time for those individuals to start listening more and talking less. Sometimes those in academics can be wrong. This is one of those times. No one is perfect.

Be a part of the solution to making the specialty desirable and appealing again to med students. People should feel they have decent job prospects when they graduate, which is not what is happening now

 

[RadOncDoc21]

Couldn't agree with this more. Feel free to DM as well.

This is straight up pathetic that some of you feel it is okay to target attendings and screenshot their twitter accounts- are you serious? Whats wrong with this field is people like you.

Yes, the job market is an issue which needs to be addressed. Yes, certain leaders of the field have made questionable decisions in the past regarding expansion of programs and yes, we need to have open discussions moving forward about how to rectify this. No one is denying that.

That does not make it okay for you all, hiding behind a veil of anonymity, to personally attack and call out individuals who seem to have an opinion that is different than yours. Seriously, if I am a prospective medical student and I'm reading this forum I would be turned off to the specialty just knowing that my so-called future/current "colleagues" think it is okay to do this. There is nothing further from medical professionalism than behaviors such as this. Obsessing over twitter accounts and feeling the need to post snarky remarks to make yourself feel better is so tacky, and pitiful. grow up.

It’s public information. I don’t use twitter so this is the only way I can get information on what’s being posted and glad people are forwarding these comments. It’s not about shaming but more about understanding the disconnect between what’s real and what isn’t.

As stated multiple times, training more residents isn’t the answer to helping the job market despite how good certain people have it now.

 

[xrthopeful]

 

[Krukenberg]

The level of incivility on here is at a new high and its beginning to feel a bit like 4chan. It makes me wonder whether some of the outrage at expansion and cheerleading of decreased application #s by established PP docs is really about screwing the academics. The last few pages of posts on this thread have shown me there are a lot of feelings of being disrespected by the ivory tower, and resentment because of it.