medstudents entering the match

[xrthopeful]

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[radoncgrad2019]

Have always heard fantastic things about Cleveland Clinic’s department and residency program. Nice to see that their PD has his head on straight.

 

[MegaVoltagePhoton]

Yes let’s drop our salaries, that will help!

 

[medgator]

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.

Yes let’s drop our salaries, that will help!

You agree with that tweet, @Krukenberg ? Talk about tone deaf.

Wonder why weichselbaum didn't bring up the salary of his hospital administrator, or CEO? Tendulkar was far more reasonable his tweets.

As a pp doc, along with many others on this forum, we stand to benefit from the cheaper labor that residency expansion provides, but feel we have a moral imperative to highlight and correct the problem. It's not fair to society or future rad oncs to deal with the mess that entirely was birthed out of academic RO.

 

[medgator]

Have always heard fantastic things about Cleveland Clinic’s department and residency program. Nice to see that their PD has his head on straight.

Great upper mid tier program imo, will prepare you for any environment. I found the didactic sessions when I rotated there to be a plus, although some felt it was a big malignant, I never got that impression.

 

[Telorad]

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.

Many in the radonc field need to be "welcomed to the real world." Sorry if you can't handle it, but you are living in a world where everything up until now was handed to you on a silver platter and the second you don't get a job in your most desired locale or are told for the first time that you are not someones first choice you lash out and try to blame other people for your problems. Then, to help yourself go to sleep at night you bash the entire medical specialty and try to dissuade other people from pursuing this field.

Again, I never said there is not an issue with the job market. I actually with agree with most of the comments being made on this thread and suggestions to potentially fix the situation (limiting expansion and having large programs cut back their spots by 1-2 etc). I myself am a senior resident(for the record, not at MSK) applying this year so am well aware of the current job market and where this field is headed and what changes need to be made to ensure graduating residents feel good about their chances of landing a job.

The issue I have is this "linking" of public comments on this forum and then to playing the role of an instigator and taking conversations completely out of context. Yes this is a public forum but let's have productive conversations with civility.

 

[Haybrant]

I’m going to post this again bc I think it’s important in understanding where the academics are coming from:

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 at sdn where we lead the exposure on issues of residency expansion/job market troubles. The academics have 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 and my advice to them is to listen more then talk.

A lot of SDN people are in anger phase. Those people too should take a step back and understand the situation and try to provide more constructive feedback, it’s the only way to get things done

 

[deleted774703]

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.

@Krukenberg you're a little off base on this one.

It's not about screwing over academics, but fighting back against the unilateral decisions they continuously make without consultation of anyone in the field

Rad onc residencies continue to open or expand and nobody outside academics has any say in it

Academic satellites continue to open and displace PP and nobody outside academics has any say in it

Academics wanting their own physicians to see 50 on treat and removing protected research time, but pay them nothing -> nobody has any say in it b/c of the oversupply

Salaries decreasing in academics and promotions continue to be difficult and nobody outside academics has any say in it

Academics hiding behind Ben Falit who is literally 1 person who has a JD and nobody has any say in it

Academics pretending like there are no negative issues in rad onc and #radoncrocks! -> nobody has any say in it

There are plenty of reasons to fight back against the academic rad onc machine.

 

[scarbrtj]

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.

I.e., get all your opinions from people in academics. Well. As has been said here many times, academics is doing great, increasing their ranks, and so on. Academics is increasingly "ruling" rad onc. They've kind of got the rad onc market cornered. Med students can save time knowing that the opinions gathered from that nightosphere should be neutral-to-favorable. I too think it's better to jaw jaw than to war war, or SDN SDN, but if you math math you'll see some issues that no dirty dozen... or even a baker's dozen... of opinions can negate.

Yes let’s drop our salaries, that will help!

Ralph's always been a bit of a verbal flamethrower but it's cool because this shows the worldview of academics. (And wow wouldn't you want a respected elder in ANY field you're in to attempt to mess with your pocketbook?) And Ralph surely is academics. A salary is what an employee makes from his employer. If by your work you generate income/billing, which all docs do obviously, your salary is that income less overhead. "Overhead" is a big, nebulous thing and a lot of the income a rad onc generates goes to other things. So what Ralph is REALLY saying by "[dropping] our salaries" (since the amount of income/billing a rad onc generates wouldn't change) is: let's allow more of our billing/income to go to other things/people. The money's gotta go somewhere. In academics, that's a big "somewhere." Dropping salaries would literally mean the ability for the mothership to acquire more satellites.

The number of rad oncs in private practice dropped ~30% in the US between 2012 and 2017 with an almost ~50% drop of rad oncs in rural/suburban locales. These non-opinion facts can spur anyone⁠—med students, residents, professors of all sorts, private practice rad oncs⁠—to say "Hey... something's wrong here."

 

[FrostyHammer]

@Krukenberg you're a little off base on this one.

It's not about screwing over academics, but fighting back against the unilateral decisions they continuously make without consultation of anyone in the field

Rad onc residencies continue to open or expand and nobody outside academics has any say in it

Academic satellites continue to open and displace PP and nobody outside academics has any say in it

Academics wanting their own physicians to see 50 on treat and removing protected research time, but pay them nothing -> nobody has any say in it b/c of the oversupply

Salaries decreasing in academics and promotions continue to be difficult and nobody outside academics has any say in it

Academics hiding behind Ben Falit who is literally 1 person who has a JD and nobody has any say in it

Academics pretending like there are no negative issues in rad onc and #radoncrocks! -> nobody has any say in it

There are plenty of reasons to fight back against the academic rad onc machine.

If you believe that, please by all means get onto ASTRO subcommittees and leadership groups! There seems to be a massive amount of inertia against doing this by the vast majority of PP radoncs; it's not the scenario that academics push the PP radoncs out of these spots, it's more because PP radoncs rarely apply out of their own will and instead incessantly complain behind a screen...

 

[RadOncG]

Yes let’s drop our salaries, that will help!

Ralph has been off his rocker for awhile. He would be just a senile old guy to be ignored but for the fact that he runs one of the most malignant radiation oncology departments in the country.

Every week they drag a resident to the front of the room to be grilled by Ralph on oncology trivia. Ensuring along the way that the resident feels terrible about themselves for missing a question. The rest of the department sits back and turns a blind eye despite everyone knowing how their current and former residents feel about the process.

The worst part is when they bring medical students in to interview they make them sit there awkwardly to watch. Ralph is proud of his firing squad.

Since medical students can go anywhere they want I would not even accept an interview from this program. Your mental health is worth more than working with this "big name" at the University of Chicago.

 

[deleted956486]

Ralph has been off his rocker for awhile. He would be just a senile old guy to be ignored but for the fact that he runs one of the most malignant radiation oncology departments in the country.

Every week they drag a resident to the front of the room to be grilled by Ralph on oncology trivia. Ensuring along the way that the resident feels terrible about themselves for missing a question. The rest of the department sits back and turns a blind eye despite everyone knowing how their current and former residents feel about the process.

The worst part is when they bring medical students in to interview they make them sit there awkwardly to watch. Ralph is proud of his firing squad.

Since medical students can go anywhere they want I would not even accept an interview from this program. Your mental health is worth more than working with this "big name" at the University of Chicago.

I wonder if that's even a term in rad onc anymore. "Big name." What does that mean anyway?

 

[deleted774703]

If you believe that, please by all means get onto ASTRO subcommittees and leadership groups! There seems to be a massive amount of inertia against doing this by the vast majority of PP radoncs; it's not the scenario that academics push the PP radoncs out of these spots, it's more because PP radoncs rarely apply out of their own will and instead incessantly complain behind a screen...

Applied and was unsuccessful this time around. Will def keep trying.

In either case, doesn’t mean you can’t set the facts straight for ppl trying to drink the kool aid

 

[deleted956486]

A few months ago on Twitter he publicly shamed a PGY-1 for being excited about radonc. It was horrifying. I felt so bad for her.

Yet people say calling this kind of thing out on SDN is unprofessional?

Will be interesting to watch the new reality. People put up with this kind of malignant BS when students are begging for residency spots, but the dynamic has fundamentally changed and in a buyer’s market programs that don’t treat residents well will not fill.

Being in high demand is a form of power to do as one wishes, and they’ve lost it.

Elitism at its finest. They can fill their spots with goldfish for all I care. Until they start showing the same level of respect they're asking for to other fellow physicians (whether PP docs, trainees, or medical students-98% of whom will become doctors)-until that level of respect is restored, these problems ain't going anywhere.

 

[Haybrant]

If you believe that, please by all means get onto ASTRO subcommittees and leadership groups! There seems to be a massive amount of inertia against doing this by the vast majority of PP radoncs; it's not the scenario that academics push the PP radoncs out of these spots, it's more because PP radoncs rarely apply out of their own will and instead incessantly complain behind a screen...

I would also add it’s just about changing things. When leaders like Ralph (totally imbecilic comment btw; why don’t Peds docs just make more ralph) believe what they do you’ll make very little headway in changing how things are. We should try but speaking here is also about warning med students about people like Ralph so they understand what they are walking into - at Match you only get one choice! Many of us were duped and feel an obligation to let med students know. That evolved from somewhere though and that was from the conversations we were having here over 3+ years ago

 

[deleted1002574]

If Twitter and SDN doesn’t rage on that comment by RW publicly then we deserve what we get. Every single person who believes in our field should be hammer tweeting about this. He is the embodiment of 80% of chairman, and how they feel about us.

If that’s the so called old school leadership, the new school should be up in arms. Deactivate ASTRO as soon as you can. Stop paying dues. Stop going to conferences. Do not enrich those that are entrenched and drunk on power.

That tweet is war. Gear up, boys and girls.

 

[medgator]

If you believe that, please by all means get onto ASTRO subcommittees and leadership groups! There seems to be a massive amount of inertia against doing this by the vast majority of PP radoncs; it's not the scenario that academics push the PP radoncs out of these spots, it's more because PP radoncs rarely apply out of their own will and instead incessantly complain behind a screen...

Look at ASTRO PAC the last decade and its goals in DC. They were not aligned with private practitioners or non-hospital based freestanding centers. Unfortunately academics have rotted ASTRO to its core.

Just look at issues like bundled payments, site neutrality, proton accountability etc. ASTRO opposed all of that for years, and many within it probably still do. They are being dragged, kicking and screaming into the new era of medicine.

 

[deleted573262]

As a med student I had no idea the level of pressure that PDs put on their residents to “spin” the program positively.

Unless you know a resident personally or they are a renegade, there is almost no chance you’ll get an honestly negative opinion out of anyone during interviews.

As a resident you have no idea who these med students are and cannot trust them to keep an opinion in confidence. If you took an applicant aside and whispered “this place sucks,” you’d live in constant fear that this would come back to you and holy hellfire would rain down upon you from above.

My home program didn’t match last year and the PD thought words were exchanged at pre interview dinners. pd gave the residents a stern talking and accused them as much, blaming the failed match on the residents.

 

[Lamount]

“Those greedy, hypocritical academics who have rotted ASTRO to it’s core... why don’t they treat us with respect?”

Is it really that much of a mystery?

You can call people names, and you can ask to be treated with respect... just don’t expect to get both.

Perhaps if more people from private practice engaged academics in respectful debate on places like twitter, it wouldn’t be so easy for them to dismiss your highly relevant perspective... and everyone would be better for it.

 

[medgator]

“Those greedy, hypocritical academics who have rotted ASTRO to it’s core... why don’t they treat us with respect?”

Didn't ask for respect I don't think? Reading would go a long way.

I merely pointed out the issues with ASTRO. Sorry those facts bother you. You prefer to not hear the truth?

 

[xrthopeful]

Everyone could do some good from stopping from finger pointing and focusing on the future. I love my job and hope that more people can find good jobs like many of us have.

Change is needed, hopefully we are going to look back ten years from now and see this as a time of transition that led to positive change

 

[radOresident]

Everyone could do some good from stopping from finger pointing and focusing on the future. I love my job and hope that more people can find good jobs like many of us have.

Change is needed, hopefully we are going to look back ten years from now and see this as a time of transition that led to positive change

or we look back and see this as the beginning of the end for radiation oncology. I don't see how anyone can believe that academics will not continue to sabotage the field as long as is feasible for them. They're not going to suddenly grow a conscience and start doing the right thing.

The job market as it stands is really, really bad. Not a single attending in my department will acknowledge this. One of our attendings has said that this is "the best job market he's seen in decades." As we continue to graduate 180+ per year and with a not insignificant chance of a looming recession pushing back retirements for older docs, I can almost guarantee we will start to see unemployed graduates in the next 5-7 years.

 

[Doctorer]

I'm an attending in academics and have a dim outlook on my (and my fellow junior attendings') prospects for career advancement.

If anyone's keeping score, put me in the "SDN malcontent" column.

 

[cujust]

Hello all - I believe it is most effective if we could discuss this in a different forum. Many academics, myself included, are willing to bridge the gap by engaging community physicians. I came from a pp family and even 30 years ago there were already undesirable trends in pp. I understand that people need to vent on SDN but this is unlikely to lead to impactful changes. A lot of people would welcome constructive input/new ideas for the common good. ASTRO is flawed, just like many organizations, it needs your active participation and advocacy to bring the improvement you desire.

Jillian Tsai
@CJTsaiMDPhD
[email protected]

 

[cujust]

New York? Take an MSK satellite for a salary that wont even let you buy a house.

This is actually incorrect. I started exclusively in the regional sites in 2014 and now I still go there once a week. The starting salary is the same across sites of MSK and most junior attendings own their properties. Those who do not chose so because MSK subsidizes housing in Manhattan.

In any case, as I said, many people are willing to have an open discussion. We don't know where to find people but you guys know how to find us I welcome your input any time.

 

[medgator]

Hello all - I believe it is most effective if we could discuss this in a different forum. Many academics, myself included, are willing to bridge the gap by engaging community physicians. I came from a pp family and even 30 years ago there were already undesirable trends in pp. I understand that people need to vent on SDN but this is unlikely to lead to impactful changes. A lot of people would welcome constructive input/new ideas for the common good. ASTRO is flawed, just like many organizations, it needs your active participation and advocacy to bring the improvement you desire.

Jillian Tsai
@CJTsaiMDPhD
[email protected]

You can thank sdn for bringing attention to this problem in the first place, which came as quite a shock to many in academics:

The Residency Training Landscape - ASTRO Blog- American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

A look at the overall training and oversight system that trains medical students to provide specialized care as a licensed physician.

www.astro.org

Revealing our identities won't do anything to address the real problems that exist. Information symmetry (much of which has been channeled through SDN) is already bringing about the change needed honestly. Just look at the most recent match and eras numbers this season as well as remarks on Twitter this weekend, if you don't believe me

 

[radOresident]

A lot of people would welcome constructive input/new ideas for the common good.

With all due respect, I don't think anyone here actually believes this. Academic chairs are looking out for their own self interest. These issues have been known for years (see Chirag Shah's red journal article) and yet every academic ignored it because it benefit them by lowering salaries and increasing the amount of cheap labor.

Talk is cheap. You all know what the problems are and what the solutions need to be (contract residenct spots back to 110-120, stop academic expansion to satellites) and you continue to do nothing about it. The academic sector of radiation oncology is absolutely not looking out for the common good.

 

[deleted1002574]

Between 350- 400 starting and some bonus is what I heard for MSKCC. Not terrible, in terms of salary but not much chance for advancement in the satellite system. It’s comparable to MDACC (mother ship and satellite) starting salary, as well, from what I’ve heard.

Dr. Tsai hopefully is speaking honestly and thus would believe in transparency, so she can give details.

Radonc is curiously poor about discussing salary openly, compared to other specialities (using SDN as the metric). You got FP and ED talking turkey, while we give these odd large ranges that offer no clarity.

 

[deleted941485]

Between 350- 400 starting and some bonus is what I heard for MSKCC. Not terrible, in terms of salary but not much chance for advancement in the satellite system. It’s comparable to MDACC (mother ship and satellite) starting salary, as well, from what I’ve heard.

Dr. Tsai hopefully is speaking honestly and thus does would believe in transparency, so she can give details.

Radonc is curiously poor about discussing salary openly, compared to other specialities (using SDN as the metric). You got FP and ED talking turkey, while we give these odd large ranges that offer no clarity.

Yeah those ED docs in the forum used to brag about the locum BFE gigs...now look at them

 

[deleted956486]

Between 350- 400 starting and some bonus is what I heard for MSKCC.

This is DELUSIONAL

This will not be posted (I'm sure you know this already).

At MSK, fresh attendings make ~ 285. At MSK, they "support the mothership" for a few years (as Dr Tsai alluded to) and then spend more time midtown when they have been blessed by the gods. What does supporting the mothership mean? 25-35 ontreats at a satellite 4-5 days a week. For comparison, how much does an NP in NYC make? 150


RE: Discussing in another forum:

I'd gladly have an open discussion with any of you, however there is a lack of trust and I will not risk my livelihood on your good word. Whether the chair at MSK or NYU can dupe a warm body into being a resident and then a satellite cog, is real low on my list of priorities.

 

[cujust]

I will refrain from commenting here further since it is hard to convince people that not all "academics" are "evil". But for those who are interested in rad onc and want to continue any meaningful discussion or information gathering, you can contact me. I can only promise on my own behalf that I do not retaliate - what good does it do to me if I bring the community folks down?

Regarding salary - I can say that MSK's starting salary (main or regional) is the same and competitive, higher than the national average, and better than some pp (since I interviewed for both at the time of graduation). I initially had 2 days of protected academic time as a regional academic physician, then now 2.5-3 days for academic pursuits. I do enjoy my job. Patient load can vary from 10s to 20s on treats. MSK pays for 15% of your total housing purchase price as down payment, interest-free, for the first 6 years. Therefore I could afford to buy a house right out of residency in the suburb with good public schools for my child. Commute is a pain but it's the reality of not living in the city. You can of course purchase a condo in the city too with the same 15% interest-free down payment benefit.

Half of my residency class went into pp and half academics. I respect my classmates who went into pp and they are some of the most brilliant people in our residency program. We continue to communicate and I think most of us are happy with their current jobs. Of course nothing is perfect and we complain to one another as well.

 

[Reaganite]

By any objective measure it is a disaster. Want to live in California? How’s $175k to start at a UCLA satellite. Meanwhile your chair just sold his pp for millions.

And don't forget the "satellites" are mostly the old Steinberg private practices...

 

[deleted1002574]

I sort of stand corrected, since Dr. Tsai says so But if it is $285k and there is the housing benefit, and 10-20 on beam, that is not bad. There’s a lot of bad going on, but let’s be real. Not unreasonable.

MDACC is state supported so salaries are posted.

 

[cujust]

Between 350- 400 starting and some bonus is what I heard for MSKCC.

Around this ballpark, lower but not too far from it. And because of the expansion many of us in the regional sites are academically focused and do have protected time as discussed above. "Advancement" really depends on your academic productivity rather than your location of practice.

 

[cujust]

I sort of stand corrected, since Dr. Tsai says so But if it is $285k and there is the housing benefit, and 10-20 on beam, that is not bad. There’s a lot of bad going on, but let’s be real. Not unreasonable.

MDACC is state supported so salaries are posted.

Also your kids go to any US accredited colleges for free - MSK pays for the tuition, but you do need to pay the tax of the tuition "gift". I don't want to sound like I'm selling for MSK but it is very tempting to want to correct the misinformation. Anyway I'm stopping from here. Good luck guys and best wishes.

 

[deleted1002574]

This is DELUSIONAL

This will not be posted (I'm sure you know this already).

At MSK, fresh attendings make ~ 285. At MSK, they "support the mothership" for a few years (as Dr Tsai alluded to) and then spend more time midtown when they have been blessed by the gods. What does supporting the mothership mean? 25-35 ontreats at a satellite 4-5 days a week. For comparison, how much does an NP in NYC make? 150


RE: Discussing in another forum:

I'd gladly have an open discussion with any of you, however there is a lack of trust and I will not risk my livelihood on your good word. Whether the chair at MSK or NYU can dupe a warm body into being a resident and then a satellite cog, is real low on my list of priorities.

Here is another example of someone stating as “fact” something they know nothing about. I backed off (even having first hand knowledge of the contract offers), because I assumed this person may have had a recent contract and there may have been changes I was unaware of.

Students- one thing I can say for sure - is do not believe any anonymous people. They can make up whatever they want. 35 on beam with no academic time for $285k in Manhattan is ridiculous. Clearly, it was a lie, just made up like usual on SDN.

This hurts us. Don’t do it. There have been many other people just stating lies. It ruins the good stuff that people are bringing on this forum. Stop the fake news. Moderator- lies on this board hurt us all. Please make note of this.

 

[xrthopeful]

Here is another example of someone stating as “fact” something they know nothing about. I backed off (even having first hand knowledge of the contract offers), because I assumed this person may have had a recent contract and there may have been changes I was unaware of.

Students- one thing I can say for sure - is do not believe any anonymous people. They can make up whatever they want. 35 on beam with no academic time for $285k in Manhattan is ridiculous. Clearly, it was a lie, just made up like usual on SDN.

This hurts us. Don’t do it. There have been many other people just stating lies. It ruins the good stuff that people are bringing on this forum. Stop the fake news. Moderator- lies on this board hurt us all. Please make note of this.

YES!

 

[medgator]

Here is another example of someone stating as “fact” something they know nothing about. I backed off (even having first hand knowledge of the contract offers), because I assumed this person may have had a recent contract and there may have been changes I was unaware of.

Students- one thing I can say for sure - is do not believe any anonymous people. They can make up whatever they want. 35 on beam with no academic time for $285k in Manhattan is ridiculous. Clearly, it was a lie, just made up like usual on SDN.

This hurts us. Don’t do it. There have been many other people just stating lies. It ruins the good stuff that people are bringing on this forum. Stop the fake news. Moderator- lies on this board hurt us all. Please make note of this.

TBH, 30-35 under beam does seem high for any academic satellite from what I have heard and recall from the interview trail, can't imagine mskcc is somehow different.

It is important we try to keep this forum as objective as possible, including calling out the bs from whichever source it is coming from

 

[Neuronix]

Moderators on this board are real “libertarian”. It’s a free for all. Won’t get shut down. We will get people telling more lies, fake salaries and work stories, etc.

How am I supposed to know what's accurate or not?

But there's another issue. I'm busy as heck and have childcare duties all weekend. So... Baby fell asleep just now and it's like *wow* this exploded.

As always, report if you want something reviewed.

 

[deleted1002574]

You guys are easily distracted. We are not here to debate if MSKCC is a good place to work. It should be a great place to work as a top institution in Rad Onc. We don't have to compare compensations with lawyers either. Students who are interested in Oncology need to be aware that Med Onc at this point might be a better option than Rad Onc when it comes to the job market.

Okay. So-
>$300k starting
Housing benefit
College paid for kids

Is that so bad? Who are we becoming?

 

[deleted1002574]

How am I supposed to know what's accurate or not?

Because the same people lie consistently. There is a benefit to open discussion, to complaining, to offering opinions. When we get into fact based things (as has happened in past), and we clarify the truth, no one says anything.

People are saying you can make $300-350k as a lawyer (1-5 years out). People are saying MSKCC attending makes peanuts when in fact they do quite well. Shut down nonsense. Keep SDN from looking bad. Why is this hard? You responded to me, yet lies remain.

 

[RadOncIMG]

Okay. So-
>$300k starting
Housing benefit
College paid for kids

Is that so bad? Who are we becoming?

First, we don't have to make a call for the students. They need data to make their own informed decisions. Dr. Tsai provided one data point regarding the job market. I will assume MSKCC is still recruiting Rad Onc so this data point is valid. I guess a more relevant question to ask is how confident we are to extrapolate this data point to a larger scale assuming MSKCC is a great place to work in Rad Onc?

 

[medgator]

Because the same people lie consistently. There is a benefit to open discussion, to complaining, to offering opinions. When we get into fact based things (as has happened in past), and we clarify the truth, no one says anything.

People are saying you can make $300-350k as a lawyer (1-5 years out). People are saying MSKCC attending makes peanuts when in fact they do quite well. Shut down nonsense. Keep SDN from looking bad. Why is this hard? You responded to me, yet lies remain.

So you're advocating for censorship. Got it. Sounds like you might fit in better at #radonc Twitter?

Sdn isn't perfect but it brought this issue front and center. Call out the bs and move on. Or as another poster has asked previously, you can consider leaving the rest of us in the "filth and mud" of SDN.

Okay. So-
>$300k starting
Housing benefit
College paid for kids

Is that so bad? Who are we becoming?

That's an upper middle class salary in Manhattan. Certainly can't afford to buy even a 2 bedroom condo in midtown, I know because my uncle bought one in 2008 for $1.2m. anyone who takes a job in Manhattan, SF, or Boston as an academic rad onc is going to have a middle to upper middle class lifestyle. End of story.

You can call me a liar. I can take it

Why a middle-class lifestyle can now cost you over $300,000 a year

To comfortably raise a family in a coastal city, "you've got to make at least $300,000 a year," writes Financial Samurai blogger Sam Dogen.

www.cnbc.com

 

[mdwithab]

So you're advocating for censorship. Got it. Sounds like you might fit in better at #radonc Twitter?

Sdn isn't perfect but it brought this issue front and center. Call out the bs and move on. Or as another poster has asked previously, you can consider leaving the rest of us in the "filth and mud" of SDN.



That's an upper middle class salary in Manhattan. Certainly can't afford to buy even a 2 bedroom condo in midtown, I know because my uncle bought one in 2008 for $1.2m. anyone who takes a job in Manhattan, SF, or Boston as an academic rad onc is going to have a middle to upper middle class lifestyle. End of story.

You can call me a liar. I can take it

Why a middle-class lifestyle can now cost you over $300,000 a year

To comfortably raise a family in a coastal city, "you've got to make at least $300,000 a year," writes Financial Samurai blogger Sam Dogen.

www.cnbc.com

This thread is really just highlighting the need for better sources of information ( and also actual data) for med students considering RadOnc. Until we have that, med students, I would really encourage you to seek out as many real-life perspectives as you can from recent grads (both PP and academics). Take whatever you read here with a massive grain of salt - and again, understand how incredible it is that the vast majority (I’d estimate >90%, though someone can fact check this) of all SDN posts on this topic are coming from the same 5-10 (anonymous) people.

 

[RadOncIMG]

This thread is really just highlighting the need for better sources of information ( and also actual data) for med students considering RadOnc. Until we have that, med students, I would really encourage you to seek out as many real-life perspectives as you can from recent grads (both PP and academics). Take whatever you read here with a massive grain of salt - and again, understand how incredible it is that the vast majority (I’d estimate >90%, though someone can fact check this) of all SDN posts on this topic are coming from the same 5-10 (anonymous) people.

My personal experience is med students respond to job market changes very quickly. Many radiology residency programs (for example, Emory) had to SOAP in 2015. They didn't have to repeat that in 2016 since the job market turned around at the same time. IR used to be an IMG-heavy fellowship. Now it is the most competitive residency thanks to high demand on the market. Assuming students make their life-long career decision based on merely SDN posts is a borderline insult to med students' intelligence in my humble opinion. They can very easily find out how happy the graduating classes are in a hospital.

 

[medgator]

This thread is really just highlighting the need for better sources of information ( and also actual data) for med students considering RadOnc. Until we have that, med students, I would really encourage you to seek out as many real-life perspectives as you can from recent grads (both PP and academics). Take whatever you read here with a massive grain of salt - and again, understand how incredible it is that the vast majority (I’d estimate >90%, though someone can fact check this) of all SDN posts on this topic are coming from the same 5-10 (anonymous) people.

Though we know the identities of those on #radonc Twitter, plenty of misinformation has been going on over there too.

Remember, some of them still have yet to acknowledge the actual problem in our specialty, one that was first highlighted and discussed here.

 

[scarbrtj]

This thread is really just highlighting the need for better sources of information ( and also actual data) for med students considering RadOnc. Until we have that, med students, I would really encourage you to seek out as many real-life perspectives as you can from recent grads (both PP and academics). Take whatever you read here with a massive grain of salt - and again, understand how incredible it is that the vast majority (I’d estimate >90%, though someone can fact check this) of all SDN posts on this topic are coming from the same 5-10 (anonymous) people.

TBH it's been more than the s a m e 5 - 1 0 a n o n y m o u s p e o p l e.

Even non-anonymous/non-SDN people. For a while really. The ASTRO infographic would give a savvy med student pause. Another non-anonymous source. As have been the ASTRO panels.

And the recent ABR exam thing also a bit of a cautionary tale re: choosing rad onc. The ABR recently essentially postponed board certification for ~33% (or more?) of rad onc grads.

Take any of the above... add in APM (which I would mention to a med student), the rapidly changing fractionation (aka indication) landscape... all adds up to less med students choosing rad onc.

These are the real issues. Not a lack of a bridged gap betwixt PP/academics. Although let me be the first to say Dr. Tsai is the first person to openly come forth on here and even attempt to do something constructive. She's the Neil Armstrong of SDN Rad Onc as far as I'm concerned. I thank her.

 

[RadOncMegatron]

TBH it's been more than the s a m e 5 - 1 0 a n o n y m o u s p e o p l e.

Even non-anonymous/non-SDN people. For a while really. The ASTRO infographic would give a savvy med student pause. Another non-anonymous source. As have been the ASTRO panels.

And the recent ABR exam thing also a bit of a cautionary tale re: choosing rad onc. The ABR recently essentially postponed board certification for ~33% (or more?) of rad onc grads.

Take any of the above... add in APM (which I would mention to a med student), the rapidly changing fractionation (aka indication) landscape... all adds up to less med students choosing rad onc.

These are the real issues. Not a lack of a bridged gap betwixt PP/academics. Although let me be the first to say Dr. Tsai is the first person to openly come forth on here and even attempt to do something constructive. She's the Neil Armstrong of SDN Rad Onc as far as I'm concerned. I thank her.

I didn’t really think this day would come, but it appears what we’ve been saying here for years has finally come to the attention of the academic elite and have their full attention. SDN has spread the truth I believe, yes there has been some hyperbole, trolling, and yes frustration that could’ve been better said nonetheless I side with SDN far more than with the academic side.

I am hoping that when the next paper is published it will not be 10 authors from high powered institutions or else it will have no credibility.

One thing is for sure SDN folks, you didn’t think we would cause this kind of change, piss off the most important people in our field and not expect some major push back did ya? They blame you (me?) so brace yourself!

 

[deleted941485]

I didn’t really think this day would come, but it appears what we’ve been saying here for years has finally come to the attention of the academic elite and have their full attention. SDN has spread the truth I believe, yes there has been some hyperbole, trolling, and yes frustration that could’ve been better said nonetheless I side with SDN far more than with the academic side.

I am hoping that when the next paper is published it will not be 10 authors from high powered institutions or else it will have no credibility.

One thing is for sure SDN folks, you didn’t think we would cause this kind of change, piss off the most important people in our field and not expect some major push back did ya? They blame you (me?) so brace yourself!

View attachment 283269

Let them try their worst.

 

[OTN]

I applaud Dr. Tsai for being the only academic Twitteratti brave enough willing to come on this forum and discuss these issues. Only by direct engagement will we be able to have meaningful discussion about the issues facing our field.

However, I disagree with the idea that this isn't the right forum for debate. Two main issues with Twitter that I can tell:

1. I graduated from a malignant program ~10 years ago. Many of those attendings are still there and in leadership positions. I have zero doubt that non-anonymous discussion could potentially lead to problems with either clinical trial cooperation or (if needed) employment down the line. Radonc is a very small field, as we all know, and we've all seen/heard/been a part of scenarios where personal vendettas had career impacts.

2. Twitter, with the way retweets are handled, doesn't allow for a back-and-forth discussion as well as a forum does. As statements that are agreed with are shared more readily, it creates a bit of an "echo chamber" where like-minded people shared similar ideas. There are some dissenting voices in the back-and-forth on Twitter, but those voices are not amplified by the academic cabal like voices in agreement are.

There's no real reason why ideas cannot be debated in this forum- the forum that began sounding the alarm about residency expansion years ago. I would encourage any physician on any side of the debate to join in, so we can begin to search for solutions to what clearly is a problem.