Programs that could be candidates for contracting/closing

[evilbooyaa]

Provide justification for why you think a program should contract or close.

Full disclosure - some of this information (and suspicious programs) is gleaned from the google spreadsheet that interviewees had this year but is validated by me actually looking. These are examples that I have evaluated myself.

Anyone who would like to is welcome to submit their reasoning to me anonymously that I will vet and post on your behalf here.

Example #1 - Baylor. Currently looking for 2 spots in the match, currently has 2 residents a year, for a total complement of 8.

Main clinical faculty at main campus (not including the 5 adjunct at the affiliated VA): 3 total faculty (Faculty)

3 main clinical faculty to 8 residents. Even if you include every single adjunct professor, they have 8 (with a 9th one at MDACC??).

Example #2 - University of Louisville. 5 clinical faculty (Faculty and Staff — School of Medicine University of Louisville), 6 residents.

Example #3 - University of Tennessee. 4 residents, 3 clinical faculty shown on the website (including Merchant, who is actually at St. Jude's): Faculty

Other programs I was putting under consideration include Cornell, Thomas Jefferson, and Tufts based on reviews from the spreadsheet but don't see anything justifiable to throw them on the list.

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[evilbooyaa]

Example #4 - Tufts - 8 attendings across 2 sites: (Rhode Island Cancer Specialists | Lifespan), what appears to be 9 residents (this information not available online, going per numbers listed elsewhere) Tufts also reportedly rotates through 3 sites, all about an hour apart from one another (see below post for explanation why this is included on the list)

Example #5 - Kentucky - 5 faculty (Our physicians in Radiation Oncology | UK HealthCare), 6 residents

 

[evilbooyaa]

Another factor that will be taken into consideration from my side - Excessive amounts of rotation sites. IMO, if you have residents mandatorily running around to 3 or 4 sites during residency (including peds electives at St. Jude's or wherever) that is a problem of you having too many residents, probably. If you have 5 or more, that is a problem of you having too many residents, definitely (IMO). Not every attending needs to have resident coverage.

Hence comes example #6 - University of Wisconsin. 15 faculty and 8 residents (so that is not the issue here), but listed as having a whopping 6 rotation sites(?!) - I am only able to confirm 4 locations, 2 of which are in Madison. If anyone has extra details to confirm or refute this, I am happy to change my opinion if 6 sites is not actually what is expected of the poor residents going to U of Wisc. *EDIT* - I have been notified that this detail of 6 sites is not true, and that University of Wisconsin rotates at a reasonable number of sites. Hence, University of Wisconsin comes off my list.

Example #7 - UTHSCSA in San Antonio. Goes back to the previous posts paradigm - 5 clinical attendings (Provider Directory), 6 residents(?). Apparently they were not taking anybody in the match this year?

Example #8 - University of Washington reportedly rotates at 6 sites. Per my review these do appear to all be in Seattle and within approximately 30-45 minutes within one another (without traffic), although it does cut directly through downtown seattle multiple times.

 

[PhotonBomb]

Baylor is hot garbage

 

[deleted1002574]

Why is a lot of sites an issue? Re: Wisconsin

 

[scarbrtj]

If there's one game I like to play it's devil's advocate. I'm here to encourage a little pragmatism.
Time was one or two years ago we couldn't have really foreseen a resident number contraction, Ken Oliver types virtue-signalling quality over quantity, a med student rad onc aversion, and the ACGME seeming to hint that there were too many residents. (BTW med students: stay averse.) What was once SDN tinfoil-hattery became specialty-wide mainstreamery. And good for us. But if we sit back like gunmen in the bell tower trying to snipe programs I don't think we will accomplish any murders. First off, and most importantly, it's mean-spirited at worst and tone-deaf at best to the residents in those programs. I know how I would feel if I were at a program and read that my program sucks. And every program we throw shade on we do from a relative state of ignorance; I'm not conceited enough to think I can Google what's a good program or bad program. (What happened to those Cal Pacific residents? I really hope it turned out OK for them. But they sure seemed stressed for a sec.) From our bell tower we hate all of the stupidity and and selfishness of those in the ivory tower. But we don't hate the students roaming the quad. We certainly don't wanna put a bullet in their skull. We will hoe more rows by pointing out the macroeconomics of all our country's ills versus its microeconomics. How can we be kind to all rad onc residents, and vicious to programs and over-expansion, at the same time? A quandry. Carry on!

 

[medgator]

City of Hope just feels like a glorified PP considering all the satellites they absorbed several years ago, and honestly, where do they expect to get jobs afterwards? SoCal??

Edit: apparently all resident experience is at the main center and satellite coverage is not required. Still does not justify it being the third or fourth program in LA imo, as it came about during the era of residency expansion

 

[Music Man Stan]

Another factor that will be taken into consideration from my side - Excessive amounts of rotation sites. IMO, if you have residents mandatorily running around to 3 or 4 sites during residency (including peds electives at St. Jude's or wherever) that is a problem of you having too many residents, probably. If you have 5 or more, that is a problem of you having too many residents, definitely (IMO). Not every attending needs to have resident coverage.

Hence comes example #6 - University of Wisconsin. 15 faculty and 8 residents (so that is not the issue here), but listed as having a whopping 6 rotation sites(?!) - I am only able to confirm 4 locations, 2 of which are in Madison. If anyone has extra details to confirm or refute this, I am happy to change my opinion if 6 sites is not actually what is expected of the poor residents going to U of Wisc.

Example #7 - UTHSCSA in San Antonio. Goes back to the previous posts paradigm - 5 clinical attendings (Provider Directory), 6 residents(?). Apparently they were not taking anybody in the match this year?

Example #8 - University of Washington reportedly rotates at 6 sites. Per my review these do appear to all be in Seattle and within approximately 30-45 minutes within one another (without traffic), although it does cut directly through downtown seattle multiple times.

I think the U Washington residents primarily travel through 3 places (Main hospital, SCCA, and Harborview which has the Gamma Knife). They do learn some prostate brachy at the VA, and occasionally go up to the proton center up north so it's not quite as terrible as it sounds.

I think the U Wisconsin residents actually only rotate at the main hospital and have an optional elective at the "east" satellite.

 

[radsisrad]

If there's one game I like to play it's devil's advocate. I'm here to encourage a little pragmatism.
Time was one or two years ago we couldn't have really foreseen a resident number contraction, Ken Oliver types virtue-signalling quality over quantity, a med student rad onc aversion, and the ACGME seeming to hint that there were too many residents. (BTW med students: stay averse.) What was once SDN tinfoil-hattery became specialty-wide mainstreamery. And good for us. But if we sit back like gunmen in the bell tower trying to snipe programs I don't think we will accomplish any murders. First off, and most importantly, it's mean-spirited at worst and tone-deaf at best to the residents in those programs. I know how I would feel if I were at a program and read that my program sucks. And every program we throw shade on we do from a relative state of ignorance; I'm not conceited enough to think I can Google what's a good program or bad program. (What happened to those Cal Pacific residents? I really hope it turned out OK for them. But they sure seemed stressed for a sec.) From our bell tower we hate all of the stupidity and and selfishness of those in the ivory tower. But we don't hate the students roaming the quad. We certainly don't wanna put a bullet in their skull. We will hoe more rows by pointing out the macroeconomics of all our country's ills versus its microeconomics. How can we be kind to all rad onc residents, and vicious to programs and over-expansion, at the same time? A quandry. Carry on!

Objective observer here: there's no room for half-measures when you're discussing the market of rad onc - your very livelihood. The solutions to your problems are going to be difficult and uncomfortable for a lot of people. Residents in the discussed programs will know not to take it personally, and anyway, any equitable solution will require that completion of training be provided to anyone under contract at a rad onc program at the time of the decision.

 

[CCJW]

Another factor that will be taken into consideration from my side - Excessive amounts of rotation sites. IMO, if you have residents mandatorily running around to 3 or 4 sites during residency (including peds electives at St. Jude's or wherever) that is a problem of you having too many residents, probably. If you have 5 or more, that is a problem of you having too many residents, definitely (IMO). Not every attending needs to have resident coverage.

Hence comes example #6 - University of Wisconsin. 15 faculty and 8 residents (so that is not the issue here), but listed as having a whopping 6 rotation sites(?!) - I am only able to confirm 4 locations, 2 of which are in Madison. If anyone has extra details to confirm or refute this, I am happy to change my opinion if 6 sites is not actually what is expected of the poor residents going to U of Wisc.

Example #7 - UTHSCSA in San Antonio. Goes back to the previous posts paradigm - 5 clinical attendings (Provider Directory), 6 residents(?). Apparently they were not taking anybody in the match this year?

Example #8 - University of Washington reportedly rotates at 6 sites. Per my review these do appear to all be in Seattle and within approximately 30-45 minutes within one another (without traffic), although it does cut directly through downtown seattle multiple times.

For the record, Wisconsin residents are only required to rotate at the main site with an optional 2 month rotation at a second (local) site.

 

[RadOnc0603]

Another factor that will be taken into consideration from my side - Excessive amounts of rotation sites. IMO, if you have residents mandatorily running around to 3 or 4 sites during residency (including peds electives at St. Jude's or wherever) that is a problem of you having too many residents, probably. If you have 5 or more, that is a problem of you having too many residents, definitely (IMO). Not every attending needs to have resident coverage.

Hence comes example #6 - University of Wisconsin. 15 faculty and 8 residents (so that is not the issue here), but listed as having a whopping 6 rotation sites(?!) - I am only able to confirm 4 locations, 2 of which are in Madison. If anyone has extra details to confirm or refute this, I am happy to change my opinion if 6 sites is not actually what is expected of the poor residents going to U of Wisc.

Example #7 - UTHSCSA in San Antonio. Goes back to the previous posts paradigm - 5 clinical attendings (Provider Directory), 6 residents(?). Apparently they were not taking anybody in the match this year?

Example #8 - University of Washington reportedly rotates at 6 sites. Per my review these do appear to all be in Seattle and within approximately 30-45 minutes within one another (without traffic), although it does cut directly through downtown seattle multiple times.

I am a recent University of Wisconsin alumni and this is not true. We have other sites we "partner" with but no residents rotate there. The faculty listed on the website all work on main campus at least a few days a week (some of the attendings cover outside clinics).

I am not sure where you are getting this info about resident rotation? (and shows the danger of going just to a website or "hearsay"). The training there is fantastic. We do NO offcampus rotations unless you want to do a more private practice "East Clinic" rotation (completely optional). We do not even have to leave UW for Pediatrics (like many places)

I would appreciate you correcting your post. Maybe you are confusing University of Washington that has numerous sites?

 

[Mandelin Rain]

Yes, UW Madison was always one of the best programs in the midwest with great education and friendly faculty.

 

[deleted1002574]

Here is the problem. This post just created an "enemies list" out of nowhere. UWisconsin is historically a good program, good faculty in terms of skill/knowledge AND kindness. It's probably a "model" program, in many ways. And, now moderator has create a list of programs to "murder" and it's on there. This is a futile exercise. Even the hate directed towards Baylor - I've worked with 2 excellent physicians who did residency there, so even if it is awful, residents are able to learn and function in the real world. I'm going to sanction Booya on this one. Bad call, bruh.

 

[deleted1002574]

Jefferson - people that have trained/worked there have become leaders in our field. One of the long standing departments with history and institutional wisdom.

Louisville - quiet program, not a whole lot gets published, but slowly and surely trains a resident or two a year and does it kindly/gently producing capable radiation oncologists.

This thread is "hot garbage"

 

[deleted1002574]

U Wash is known as malignant and had a faculty exodus a few years ago, but again, trainees come out ready to go and go on to good careers. This is some weird McCarthy **** to just programs which you don't like on a list for elimination

 

[Lamount]

Speaking ill of a program without first-hand knowledge also (perhaps unintentionally) calls into question the credentials of its former and current trainees. If someone comes forward and says "I trained at X, and I wouldn't recommend this program to others'... that is a well-sourced opinion and helpful to future applicants. But quickly googling a small program and sharing your snap judgements without direct knowledge is silly.

Stop looking for villains.

I support closing/contracting SDN forums and I think this one in particular is an excellent candidate for closure.

 

[firewicket]

Nah, I think this is a fair thread.
Applicants should be aware.
The rise in spots and market demands via academics expanding programs...it is completely warranted to have a "hit list" for guilty programs that are doing a poor job training. My program for instance did a poor job training.
I basically learned from having a ton of time to read. That is not how it should be.

 

[deleted1002574]

Nah, I think this is a fair thread.
Applicants should be aware.
The rise in spots and market demands via academics expanding programs...it is completely warranted to have a "hit list" for guilty programs that are doing a poor job training. My program for instance did a poor job training.
I basically learned from having a ton of time to read. That is not how it should be.

Sloan Kettering is lousy. It's too busy there and too many people are researching for cure the cancer. It needs to be closed for training.

Emory is in Atlanta and has too much traffic and multiple sites. This requires driving and bad for environment. END THE PROGRAM.

 

[KHE88]

Oh, this is just silly.

Everyone knows Rutgers has the best biryani. That's a top tier program.

Baylor Scott and White has no biryanis. Shut it down!!!

 

[deleted1002574]

Oh, this is just silly.

Everyone knows Rutgers has the best biryani. That's a top tier program.

Baylor Scott and White has no biryanis. Shut it down!!!

From not knowing what Biryani is to now knowing one of the regional hotbeds of biryani innovation ... so proud of our Affluent Agrarian, our Bucolic Billionaire ...

 

[Lamount]

Nah, I think this is a fair thread.
Applicants should be aware.
The rise in spots and market demands via academics expanding programs...it is completely warranted to have a "hit list" for guilty programs that are doing a poor job training. My program for instance did a poor job training.
I basically learned from having a ton of time to read. That is not how it should be.

I once got my hair cut at a certain barber and the guy who owned the bakery next door new someone who trained at MDACC and...

Your opinion regarding your program is invaluable... the rest of this is simply sharing some, well, some biryani 6-12 hours after its consumption.

 

[evilbooyaa]

For the record, Wisconsin residents are only required to rotate at the main site with an optional 2 month rotation at a second (local) site.

I am a recent University of Wisconsin alumni and this is not true. We have other sites we "partner" with but no residents rotate there. The faculty listed on the website all work on main campus at least a few days a week (some of the attendings cover outside clinics).

I am not sure where you are getting this info about resident rotation? (and shows the danger of going just to a website or "hearsay"). The training there is fantastic. We do NO offcampus rotations unless you want to do a more private practice "East Clinic" rotation (completely optional). We do not even have to leave UW for Pediatrics (like many places)

I would appreciate you correcting your post. Maybe you are confusing University of Washington that has numerous sites?

Thank you for your inputs. I will correct my previous post accordingly.

 

[evilbooyaa]

Why is a lot of sites an issue? Re: Wisconsin

This is my personal opinion. I think residents being at multiple sites is a fracturing of the resident experience and comradarie and is likely done to push residents out to cover satellite positions when similar training could be achieved for a lower number of residents at the main hospital. There can be exceptions to this, and it also matters the total distance of which the residents are expected to travel for their rotations, but it's a factor for consideration. Some may call it grasping at straws, for which folks are allowed to have their own personal opinions.

 

[deleted1002574]

So, a program should be shut down because it doesn't offer as much camaraderie or excessive commute times?

Some places have a women's hospital, a children's hospital, a heavy SRS/SBRT focused center, a gal in the community who does a 100 seed implants a year, all at different sites. This type of a program allows for a resident to get a lot of varied, high volume experience. Or, they can stay at one site, get like 7 seed cases and 4 T and O's in a 4 year residency.

This is the most absurd rationale I have ever heard for closing a program down. And, you're right about having an opinion. Anonymously saying that U-Wisconsin should be shut down because you heard it may have several sites is poison. Yes, it is corrected, but this is SDN looking bad.

What "real" benefit does this list have, @evilbooyaa ? You may hurt some programs and residents, because you don't know facts. What if the UW people didn't speak up? Now we have it on here written that UWisconsin is a trash program.

 

[KHE88]

This is my personal opinion. I think residents being at multiple sites is a fracturing of the resident experience and comradarie and is likely done to push residents out to cover satellite positions when similar training could be achieved for a lower number of residents at the main hospital. There can be exceptions to this, and it also matters the total distance of which the residents are expected to travel for their rotations, but it's a factor for consideration. Some may call it grasping at straws, for which folks are allowed to have their own personal opinions.

I am not familiar with the situation at Wisconsin (always heard it was a great program), but the situation with UW was common knowledge regarding residents spending hours driving all over the city. Telling when a program with such high name recognition failed to match during the height of rad onc competitiveness 5-6 years ago.

 

[KHE88]

So, a program should be shut down because it doesn't offer as much camaraderie or excessive commute times?

Some places have a women's hospital, a children's hospital, a heavy SRS/SBRT focused center, a gal in the community who does a 100 seed implants a year, all at different sites. This type of a program allows for a resident to get a lot of varied, high volume experience. Or, they can stay at one site, get like 7 seed cases and 4 T and O's in a 4 year residency.

I do agree that the vast majority of training should be done at a single center. A good high volume cancer center should offer all of this stuff on a single campus. Peds is a reasonable exception.

 

[deleted1002574]

JHH hardly gets any seed experience any more on site and that is high-value care. SHUT IT DOWN. Nor do most residencies any more, especially those in same town as a Urorad. SHUT THEM DOWN

 

[evilbooyaa]

So, a program should be shut down because it doesn't offer as much camaraderie or excessive commute times?

Some places have a women's hospital, a children's hospital, a heavy SRS/SBRT focused center, a gal in the community who does a 100 seed implants a year, all at different sites. This type of a program allows for a resident to get a lot of varied, high volume experience. Or, they can stay at one site, get like 7 seed cases and 4 T and O's in a 4 year residency.

This is the most absurd rationale I have ever heard for closing a program down. And, you're right about having an opinion. Anonymously saying that U-Wisconsin should be shut down because you heard it may have several sites is poison. Yes, it is corrected, but this is SDN looking bad.

What "real" benefit does this list have, @evilbooyaa ? You may hurt some programs and residents, because you don't know facts. What if the UW people didn't speak up? Now we have it on here written that UWisconsin is a trash program.

Listen, mang. This was brought on by discussions of what is a 'low quality' program. Which is just a code word for the size of the program for most academics. These are my opinions on things that I, personally, knowing what I know now, would make me feel that a program is more likely to be low quality. I'm happy to listen to others who have other opinions on programs that should close.

There NEEDS to be a conversation about this because otherwise, even if every program just stays open with the same amount of residency openings for the foreseeable future and is willing to take IMGs en masse to fill the spots then we are no closer to fixing the job market and oversupply issue.

I'm willing to be humble and admit when I was wrong as I did with U of Wisconsin.

You are more than welcome to your opinion that my criteria for what may factor a low quality program may not be palatable to you.

Let me put it this way - if Program A has you rotate at 5 sites for your educational experience, and Program B can offer you the SAME educational experience and have you only rotate at 1-2 sites, which program is better? I'm not saying Program A is BAD but, IMO, it's worse than program B.


This is obviously NOT a knock on the residents at these programs. They certainly could not have been expected to know any better. I have no doubt that residents from the residencies on this list would be fine clinicians. Hannehman did its residents a favor when it closed and got mostly absorbed by Jefferson. Most of these programs have more than 4 residents meaning that they could contract without a full closure.

 

[evilbooyaa]

City of Hope just feels like a glorified PP considering all the satellites they absorbed several years ago, and honestly, where do they expect to get jobs afterwards? SoCal??

City of Hope is a part of NCCN and has 8 attendings (Radiation Oncologists near Duarte and Los Angeles | City of Hope Cancer Center) at their main campus, and per spreadsheet there is a 1 month peds elective otherwise all rotations are at main site, with no one mentioning coverage of satellites. What's your beef with them?

Speaking ill of a program without first-hand knowledge also (perhaps unintentionally) calls into question the credentials of its former and current trainees. If someone comes forward and says "I trained at X, and I wouldn't recommend this program to others'... that is a well-sourced opinion and helpful to future applicants. But quickly googling a small program and sharing your snap judgements without direct knowledge is silly.

Stop looking for villains.

I support closing/contracting SDN forums and I think this one in particular is an excellent candidate for closure.

Do you really think, especially a current resident, will come on SDN and blast his/her own program? Do you think previous grads will give up the anonymity to say, openly "I trained at X and we did shady **** like make up case numbers" as was recently said in another thread?

To @ROFallingDown and @Lamount - I challenge you on this. You both seem to understand the need for residency contraction. If not, then we'll just go our separate ways since we are clearly too far apart on this issue. Since my reasons are 'hot garbage', tell me how you're going to contract residency spots. You have all the power of the RRC - what would be your plan on how to contract residency spots?

 

[deleted1002574]

- Reduction in active spots, not shutting down random departments based on a google doc / reddit list.
- Objective measures, not clinical sites or too much driving
- What programs deliver poor residents? How is a poor resident defined? Board pass rates? Jobs?

To even put Jeff or UWisc or UWash on the list (despite some rumors, despite some malignancy in past) seems to indicate that you are engaging in haphazard rumor-mongoring and very person-specific "traits" that programs "shouldn't" have.

Is there something that indicates that multiple sites = poor training, other than your general gestalt?

This seems like the list that Alligator what put together - the typical "Mayo AZ, WVU, Hollywood Upstairs" and whatever else his favorite targets are. Just based on general dislike of a program, it's relative new-ness.

This isn't how to get stuff done. But, you're right. Let's go our separate ways on this. Make your fact-challenged Murder List and let everyone see it. Let's badmouth as many programs, as possible.

 

[evilbooyaa]

The title literally says 'contracting/closing'. Contracting is a reduction in active spots. Not sure how you feel like we're disagreeing on point 1. Every program I mentioned that had more than 4 residents (basically all of them) I'm suggesting should contract by 1-4 residents (dependent on the program) based on the number of faculty they currently have.

What objective measure? This is politicking at its finest. Boards pass rates? In-service percentiles?
As an aside - you seem to clearly have an issue with the clinical sites aspect, as the part about attendings not having 100% coverage (which makes up the vast majority of the list) you haven't said a peep about. If it will get you working with me rather than against me, I'm happy to omit U of Washington, or replace the criteria with their giant faculty exodus in recent history, or something else that won't rustle your jimmies as much.

How about this as an objective measure - if you reach the SOAP more than 2 years in a row you lose a spot. For every year that you continue to have to SOAP you continue to lose one spot out of your complement. If you reach a point where you don't have 4 residents, you get shutdown.

You are happy to simply poke holes in others opinions/thought processes but have zero constructive input on what the steps should be.

 

[Lamount]

Do you really think, especially a current resident, will come on SDN and blast his/her own program? Do you think previous grads will give up the anonymity to say, openly "I trained at X and we did shady **** like make up case numbers" as was recently said in another thread?

To @ROFallingDown and @Lamount - I challenge you on this. You both seem to understand the need for residency contraction. If not, then we'll just go our separate ways since we are clearly too far apart on this issue. Since my reasons are 'hot garbage', tell me how you're going to contract residency spots. You have all the power of the RRC - what would be your plan on how to contract residency spots?

1) If you absolutely feel compelled to make a black list, solicit anonymous posters with first-hand knowledge to share their experiences... and repost for us. If no one comes forward with something bad to say about program X, then leave X off your "list". There should be a high bar for badmouthing a particular residency on public forums, lest you step in it like you did with U Wisc. Bear in mind, when you defame a residency program, you may think you are simply targeting their "greedy" chairs or whatever, but what are actually doing is calling the past and present residents 'poorly trained'. Personally, I think the premise of this forum is in poor taste.

2) There are a number of ways to fairly limit residency expansion: 1) mandate a 1:1 teaching faculty to resident ratio; 2) force contraction of programs who cannot fill available residency spots in the match 2 years in a row; 3) mandate that physics and radiobiology are taught by either department faculty, or faculty from a nearby institution. If radbio or physics courses are shared, they can only be shared between two programs.

 

[deleted1002574]

Sigh... it's not poking holes

It's random, anonymous ****-posting that a moderator shouldn't allow, much less start up themselves. Continue if you really feel like you're helping the field and lowering spots by just posting gibberish reasons for why a program should be shut down.

I've been wrong on this board before and owned it. This is a bad look. Take an objective look at the premise and what the possible outcomes could be for residents and these programs.

Also, if you had a thread about "How do we best go about figuring out how to lower spots and consider which programs should shut down?" you can get some of my feedback. You made a shutdown list - "Let's list programs and trash them" and it's was fact challenged from the get go.

 

[medgator]

City of Hope is a part of NCCN and has 8 attendings (Radiation Oncologists near Duarte and Los Angeles | City of Hope Cancer Center) at their main campus, and per spreadsheet there is a 1 month peds elective otherwise all rotations are at main site, with no one mentioning coverage of satellites. What's your beef with them?

They absorbed a ton of private satellites over the years, assumed that's how they were able to justify the program.

Even if that's not the case, did LA really need more programs on top of UCLA and USC? Throw cedars into that mix too. $225k starting salaries this decade in pp there because there are so many looking for a job...

 

[medgator]

This seems like the list that Alligator what put together - the typical "Mayo AZ, WVU, Hollywood Upstairs" and whatever else his favorite targets are. Just based on general dislike of a program, it's relative new-ness.

If we didn't need spots 135-200, shouldn't those programs that have been expanded/created to create the oversupply be called out as such?

 

[deleted1002574]

LA's metro area is 12 million, and they have USC, UCLA, CoH, Cedars, Kaiser. Pittsburgh metro area is 2.3 million and they have 2 programs. So, they have nearly 6x population, but only 2 more residences... Cleveland metro is even smaller than Pittsburgh. Has two programs. Detroit metro has 4.2 million people and four residencies. 1/3 the population, same number of residencies as LA. Madison + Milwaukee is 2.1 million people. 2 programs.

So, most places have 1 residency program per million. LA could have 12. I'd say they are fine...

If you're going to go after places, I'd say target small/mid sized cities with more than one residency and have them join forces and cut a few spots.

 

[medgator]

LA's metro area is 12 million, and they have USC, UCLA, CoH, Cedars, Kaiser. Pittsburgh metro area is 2.3 million and they have 2 programs. So, they have nearly 6x population, but only 2 more residences... Cleveland metro is even smaller than Pittsburgh. Has two programs. Detroit metro has 4.2 million people and four residencies. 1/3 the population, same number of residencies as LA. Madison + Milwaukee is 2.1 million people. 2 programs.

So, most places have 1 residency program per million. LA could have 12. I'd say they are fine...

If you're going to go after places, I'd say target small/mid sized cities with more than one residency and have them join forces and cut a few spots.

LA jobs were slim pickings with some of the lowest starting salaries before they doubled the number of programs in the metro area.

And i still see more postings for oh and Western/Central pa jobs than i do LA ones.

Just sayin'.

 

[deleted1002574]

So, you want to put a training program in Rhinelander or Minot? Chambersberg? Peoria, IL?

 

[evilbooyaa]

1) If you absolutely feel compelled to make a black list, solicit anonymous posters with first-hand knowledge to share their experiences... and repost for us. If no one comes forward with something bad to say about program X, then leave X off your "list". There should be a high bar for badmouthing a particular residency on public forums, lest you step in it like you did with U Wisc. Bear in mind, when you defame a residency program, you may think you are simply targeting their "greedy" chairs or whatever, but what are actually doing is calling the past and present residents 'poorly trained'. Personally, I think the premise of this forum is in poor taste.

2) There are a number of ways to fairly limit residency expansion: 1) mandate a 1:1 teaching faculty to resident ratio; 2) force contraction of programs who cannot fill available residency spots in the match 2 years in a row; 3) mandate that physics and radiobiology are taught by either department faculty, or faculty from a nearby institution. If radbio or physics courses are shared, they can only be shared between two programs.

6 out of 7 examples fall under the first point you mentioned as a way to limit residency expansion. I agree with your points 1 and 2 obviously, and think point 3 is reasonable.

I have tried repeatedly in the past to get people to anonymously inform me about their residency experience and heard crickets. It's time for a more dramatic step. Not all steps will go smoothly as my call out of U of Wisconsin did, but I am comfortable being wrong from time to time.

 

[cohthrowaway123]

City of Hope just feels like a glorified PP considering all the satellites they absorbed several years ago, and honestly, where do they expect to get jobs afterwards? SoCal??

I'm a resident at City of Hope. Sorry, I feel like I have to address this because this is objectively a mischaracterization and this kind of post does unfairly influence people's real perceptions of programs. City of Hope is not a glorified PP at all. It's one of the biggest cancer centers in America and a research powerhouse. In the rad onc department there is quality research ongoing, even if City of Hope doesn't have the national name recognition within radiation oncology of some more established programs.

Of course I am biased, but I feel that we have a very good program. In terms of my own experience, I feel well-educated and well-trained. I'm on pace to finish with 80th-90th percentile case volume nationally with a diverse case mix and significant brachytherapy experience. We have quality attending-led didactics and plenty of research opportunity, as well as a very supportive culture. We do not rotate at satellites and the satellite network plays zero role in "justifying the program." Graduates from our program have all found good jobs. Our graduating resident last year landed a physician scientist academic position, which wouldn't be possible if it truly were a glorified PP. Although I am anxious about the future job search as I'm sure many others are, I feel fortunate to have matched here, and I think it's actually a significant advantage to be here compared to other programs I had considered.

I definitely agree that residency expansion is a huge problem, but as others have pointed out, calling out programs that you don't personally know anything about seems like a counterproductive exercise. In general I believe that contracting existing spots is likely more palatable and actionable compared to program closure -- the practical way forward would likely to be put requirements and restrictions in place that would force programs to decrease their existing complement. There is some good discussion in this thread regarding this and likely we should focus there.

 

[deleted1002574]

Thanks COH for showing again why this is a stupid thread. Basically, each program that gets trashed is going to have someone explain why they aren’t. Waiting for bcm2022 next ...

 

[PhotonBomb]

BCM is straight bad by any measure. City of Hope I’ve always said is fine.

Some of the other programs that have been ‘defended’ here reflect how out of touch you are with Modern rad onc. Jefferson is a terrible training environment in the current state. I hope they improve

 

[deleted1002574]

Based on a random internet dude that just is trashing programs, a program with a long history should be shut down. Okay, buddy.

 

[PhotonBomb]

Based on a random internet dude that just is trashing programs, a program with a long history should be shut down. Okay, buddy.

I’m aware of the program and lots of problems that exist there that have been discussed ad nauseum on this board as well as on the google doc over the recent years.

Also not saying it needs to be shut down btw it’s just not a place people with any choices at all should be ranking.

I urge you to get with the program.

 

[PhotonBomb]

@PhotonBomb

In your esteemed judgment, what's the measure of a good vs. bad "modern" radiation oncologist?

Year 1 as an attending, PP or academics, freshly-minted and squeaky clean.

I’m not talking about the grads of these programs in any way. I’m not saying they are not good.

Im talking about the programs.

I don’t really care to engage much with ROFallingDown on this as he trained ten plus years ago and really has no clue what’s happening out there.

As a new grad, you are well aware there are plenty of ****ty programs that just don’t give a **** about trainees past them being a monkey for notes and contours

This is like the least controversial thing ever said in this forum, and somehow it has triggered ROFallingDown.

 

[RickyScott]

I am going to start beating the drum that the quality of the program is not very important and other factors like when program started should be taken into account. A suburb of New York like Long Island should not have any programs period, let alone 2: LIJ ,stony brook. (And Cornell in queens which is basically Long Island, and another program that should close.

Chairman of LIJ has already penned ugly editorial denying any issue with job market. Programs need to close that opened recently umdnj, Dartmouth, west verginia, Arkansas, missippi, cedars, city of hope, etc. also larger programs like mskcc have to start cutting spots. Certainly anyone who attempts to add spots like Case western obviously cares nothing about residents or future of our field

 

[PhotonBomb]

‘The quality of the program is not very important’

Okay Paul Wallner.
Luckily the people who dictate which programs will match and which don’t - aka applicants - DO care about programs quality and will vote with their ranks.

 

[PhotonBomb]

Would also add that it’s funny to see the dichotomy here about people that actually care about the resident experience (current residents, people who are recent grads) and the people that have been out in practice for a while

 

[RickyScott]

Would also add that it’s funny to see the dichotomy here about people that actually care about the resident experience (current residents, people who are recent grads) and the people that have been out in practice for a while

BCM is straight bad by any measure. City of Hope I’ve always said is fine.

Some of the other programs that have been ‘defended’ here reflect how out of touch you are with Modern rad onc. Jefferson is a terrible training environment in the current state. I hope they improve

I absolutely care about quality of resident experience, I am just not sure it should be a major factor in who should close. Jeff has always been a miserable program, and Maryland less so (ex Jeff guys) but always produced decent grads. Certainly Jeff given its history in this field is not going to close. It’s much more persuasive to argue why did LIJ and stony break, or even Cornell need to open (nyc underserved?)

I am sure mayo programs are decent but outside of main campus absolutely need to be thrown out.

 

[PhotonBomb]

Idk I think the idea of a externally mandated closure is too unlikely to consider.

I think if some programs truly do go unmatched year after year that will essentially be slow death without hospice