Ranking the worst rad onc programs in the nation - for med students

[gmsquid]

I think resident led didactics are fine as long as attendings are there to correct misinformation and provide their real-life experience.

I agree. There’s also value in researching and studying the topic yourself too. They key was the structure Attendings also gave lectures as well but we had a core curriculum of topics that we covered each year and rotated rare topics. Twos got easy stuff like gbm and anal cancer. Fives got harder stuff like gastric cancer.

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[gmsquid]

There is all sorts of scut that is not educational and is a purely service obligation that I have seen and heard of residents having to do, the vast majority of which has ZERO educational value, either ever (like calling an outside facility to obtain records because there are no ancillary staff or physicists won't do it), or after doing maybe some concrete number of times (like contouring normals, let's say 5-10 times per anatomic site).

I would also argue that service obligation is important. Learning to function, write notes, and time manage and do the indirect patient care things of medicine is important. We never cry that part of being an im resident is obtaining records or calling other physicians. I mean having the infrastructure to do it is important (I.e having somebody who can call or a secretary to go to), but a resident should understand that coordination of care and managing a service at an appropriate level foe their education is part of the job and pathway to independence. Experience is a crucial part of medical education. Yeah 95% of weekly reviews are the same old but seeing the 5% that are complicated or develop clinical symptoms concerning for recurrence can only happen when you see enough.

 

[elementaryschooleconomics]

I would also argue that service obligation is important. Learning to function, write notes, and time manage and do the indirect patient care things of medicine is important. We never cry that part of being an im resident is obtaining records or calling other physicians. I mean having the infrastructure to do it is important (I.e having somebody who can call or a secretary to go to), but a resident should understand that coordination of care and managing a service at an appropriate level foe their education is part of the job and pathway to independence. Experience is a crucial part of medical education. Yeah 95% of weekly reviews are the same old but seeing the 5% that are complicated or develop clinical symptoms concerning for recurrence can only happen when you see enough.

It's essentially the "Rocky IV" argument of residency training. Who got the better training, the Russian with the high-tech equipment and everything handed to him, meaning all he had to focus on was getting stronger? Or Rocky, who had to build and maintain his entire training system out in the snowy wilderness? Pushing aside the "American exceptionalism" the movie is trying to push, I don't think there's a clear answer.

I totally agree that needing hands-on experience with indirect patient care tasks is very important. However, in an ideal world, the only places approved to have RadOnc residency programs should have the infrastructure in place where this is not generally "necessary" for the majority of tasks. My program accidentally strikes a weird "balance" (and I use that term cautiously) where most services have most admin tasks handled most of the time. Then, there are services which have weird components to them which the residents are required to handle. There is a piece of me that believes "learning" these tasks is valuable, but how many times do I need to schedule an MRI appointment before I figure out how to do it?

A long time ago, far far away, I was a secretary myself, so perhaps I resent getting told I'm "learning" a job I did when I was 19.

 

[RadOncDoc21]

It's essentially the "Rocky IV" argument of residency training. Who got the better training, the Russian with the high-tech equipment and everything handed to him, meaning all he had to focus on was getting stronger? Or Rocky, who had to build and maintain his entire training system out in the snowy wilderness? Pushing aside the "American exceptionalism" the movie is trying to push, I don't think there's a clear answer.

I totally agree that needing hands-on experience with indirect patient care tasks is very important. However, in an ideal world, the only places approved to have RadOnc residency programs should have the infrastructure in place where this is not generally "necessary" for the majority of tasks. My program accidentally strikes a weird "balance" (and I use that term cautiously) where most services have most admin tasks handled most of the time. Then, there are services which have weird components to them which the residents are required to handle. There is a piece of me that believes "learning" these tasks is valuable, but how many times do I need to schedule an MRI appointment before I figure out how to do it?

A long time ago, far far away, I was a secretary myself, so perhaps I resent getting told I'm "learning" a job I did when I was 19.

That Russian killed Apollo Creed, the same guy Rocky was hugging on the beach. No reason for that at all!

I myself am guilty of giving residents trivial task but I usually award them with an afternoon off to either read or smoke crack. I agree, residency is a balance and it’s really on the resident to obtain as much knowledge as they can either through their own merits or obtaining information through others. I learned the most about gamma knife through a neurosurgeon and learned how to scope during my ENT rotation. My rad onc residency wasn’t the best but it put me in a position to learn. Sometimes you just have to make lemonade out of hot sauce.

 

[elementaryschooleconomics]

That Russian killed Apollo Creed, the same guy Rocky was hugging on the beach. No reason for that at all!

I myself am guilty of giving residents trivial task but I usually award them with an afternoon off to either read or smoke crack. I agree, residency is a balance and it’s really on the resident to obtain as much knowledge as they can either through their own merits or obtaining information through others. I learned the most about gamma knife through a neurosurgeon and learned how to scope during my ENT rotation. My rad onc residency wasn’t the best but it put me in a position to learn. Sometimes you just have to make lemonade out of hot sauce.

I'm working "sometimes you gotta make lemonade outta hot sauce" into a conversation with a PGY-2 today...

 

[gmsquid]

That Russian killed Apollo Creed, the same guy Rocky was hugging on the beach. No reason for that at all!

I myself am guilty of giving residents trivial task but I usually award them with an afternoon off to either read or smoke crack. I agree, residency is a balance and it’s really on the resident to obtain as much knowledge as they can either through their own merits or obtaining information through others. I learned the most about gamma knife through a neurosurgeon and learned how to scope during my ENT rotation. My rad onc residency wasn’t the best but it put me in a position to learn. Sometimes you just have to make lemonade out of hot sauce.

Redirect Notice

 

[Neuronix]

Just for the sake of argument, imagine a residency program where:

Clinic for attendings is 1-2 days a week
Residents work with only one attending at a time
There is little to no inpatient or call responsibility
All lectures are given by attendings
Resident evaluations are taken extremely seriously. Your attendings jobs, promotions, and bonuses depend on good resident evaluations, so attendings treat residents like VIPs
Attendings are used to working without residents and many of them rarely have residents
Residents get tons of vacation and educational days, and can easily skip out on clinic as much as they want
Residents frequently post on social media about how easy residency is and brag about how much fun they're having doing things outside of work even during usual business hours

Is that a good training program? Why or why not?

 

[kimplera]

Just for the sake of argument, imagine a residency program where:

Clinic for attendings is 1-2 days a week
Residents work with only one attending at a time
There is little to no inpatient or call responsibility
All lectures are given by attendings
Resident evaluations are taken extremely seriously. Your attendings jobs, promotions, and bonuses depend on good resident evaluations, so attendings treat residents like VIPs
Attendings are used to working without residents and many of them rarely have residents
Residents get tons of vacation and educational days, and can easily skip out on clinic as much as they want
Residents frequently post on social media about how easy residency is and brag about how much fun they're having doing things outside of work even during usual business hours

Is that a good training program? Why or why not?

No>possibly (you left out a key issue - number of cases) - i'd argue that it would be very hard in such a program to get your "numbers" and more importantly, you'd struggle to see enough followup and on treatment patients to be able to handle the odd presentations and recurrences that walk through my door, not every week, but monthly. There is some aspect of medical training that requires providing care.
There can be real value in residents giving lectures - you learn much more from preparation than just sitting and listening - active vs. passive.
I see real value in having resident evaluations taken seriously - tying bonuses to resident evaluations (with substantive feedback) is fine - not entirely based on that feedback, but as a part of the calculation.
Also - i trained at a program where residents didn't do the peer-to-peer calls - struggled with these out of residency because i had no experience - this is an example of you may not know the value of the work you do until long after it is done - wax on, wax off...(just started watching cobra kai)

 

[Neuronix]

No>possibly (you left out a key issue - number of cases) - i'd argue that it would be very hard in such a program to get your "numbers"

I think the current standard of 450 of essentially any case with a few minimums thrown in is a ridiculously low bar with essentially no meaning.

There is no quality assurance or auditing as to what counts as a "case" for an ACGME case log. Do you have to do everything? Do you do nothing but draw a few circles? I have seen manipulation at different places to get numbers up or down--i.e. very easy to just not log cases or get a low case resident in on a few simple cases to boost their numbers.

I see real value in having resident evaluations taken seriously - tying bonuses to resident evaluations (with substantive feedback) is fine - not entirely based on that feedback, but as a part of the calculation.

What do you do if the residents complain that they're working too hard (even if nowhere near ACGME limits), that you're too critical, or that they have to do too much scut like those peer to peers you mentioned? It's a little hard to brush that aside when you are personally penalized for that feedback.

 

[rid1]

Here is my list. Would not attend any of these programs in this climate.

28. Stony brook
27. Uthsca
26. UCirvine
25.Loyola
24. Dartmouth
23. Upmc
22 Mayo Jax
21. SUNY downstate
20. SUNY upstate
19.TJU
18. ULouisville
17. UC Davis
16. Case Western
15. OU
14. Kentucky
13. Miami
12. Northshore LIJ
11. Texas a&m
10. UMississippi
9. Columbia
8. Alleghany
7. Kansas
6. UTennessee
5. Arkansas
4. MUSC
3. Baylor
2. WVU
1. NY Presby Methodist

Hi, SUNY Upstate resident here. Biases aside, I don't think Upstate makes the list:
1. 100% employment rate in the past 7+ years (including this year)
2. 100% board pass rate in the past 7+ years (even 2 years ago)
3. Get all our requirements in house, no need for away rotations, honestly no stress from this standpoint at all
4. Non-malignant, very responsive PDs and PC
5. Sweet vacation policy
I'm happy to hear other peoples' opinions from the outside.

 

[thecarbonionangle]

Delivery and execution is very important. Some places use this excuse for dumping on residents despite minimal to zero educational value. Do residents have to see all inpatients? or are attendings selecting good cases and sitting down discussing case and important details and their approach? Palliative cases can be some of the most difficult. Is the resident making all lectures and giving a lecture to an empty audience and attendings are too “busy” to attend or are attendings part of a lively well attended packed audience informational educational discussion? Are residents contouring all normals always? Always getting records? this at some point is straight up scut. Is attending sitting down with resident to do peer to peer and giving feedback, being immediately available to help the case get approved or is this just dumped on resident with zero feedback, “just take care of this”?

yes details and execution matters

 

[kimplera]

I think the current standard of 450 of essentially any case with a few minimums thrown in is a ridiculously low bar with essentially no meaning.

There is no quality assurance or auditing as to what counts as a "case" for an ACGME case log. Do you have to do everything? Do you do nothing but draw a few circles? I have seen manipulation at different places to get numbers up or down--i.e. very easy to just not log cases or get a low case resident in on a few simple cases to boost their numbers.



What do you do if the residents complain that they're working too hard (even if nowhere near ACGME limits), that you're too critical, or that they have to do too much scut like those peer to peers you mentioned? It's a little hard to brush that aside when you are personally penalized for that feedback.

"when i was your age..."

but seriously, that's where i think there has to be discretion involved in how that feedback is incorporated. Many programs don't "value" the things they claim are important and so faculty aren't incentivized to put effort into them.

totally agree on case logs - it's a poor surrogate for experience that is easy to measure and track

 

[kimplera]

Delivery and execution is very important. Some places use this excuse for dumping on residents despite minimal to zero educational value. Do residents have to see all inpatients? or are attendings selecting good cases and sitting down discussing case and important details and their approach? Palliative cases can be some of the most difficult. Is the resident making all lectures and giving a lecture to an empty audience and attendings are too “busy” to attend or are attendings part of a lively well attended packed audience informational educational discussion? Are residents contouring all normals always? Always getting records? this at some point is straight up scut. Is attending sitting down with resident to do peer to peer and giving feedback, being immediately available to help the case get approved or is this just dumped on resident with zero feedback, “just take care of this”?

yes details and execution matters

re: contouring normals - if the resident does normal structures it's scut but if the attending does them it's work? i don't think i agree with this - may be because i treat H&N and there is great case to case variability in normal structures that help you define your target volumes so i think they go hand in hand

 

[thecarbonionangle]

re: contouring normals - if the resident does normal structures it's scut but if the attending does them it's work? i don't think i agree with this - may be because i treat H&N and there is great case to case variability in normal structures that help you define your target volumes so i think they go hand in hand

I understand your point. As an attending you are paid well. you have passed boards or almost done depending on how many years out you are. i don’t see a problem with someone being paid to work to do work. I believe residencies are supposed to fundamentally educate people. Residents are paid a menial salary. Like i said delivery is all that matters. If your goal is to have resident know how to contour the cochlea, learn that you like your medial parotid lobe contoured a certain way, learn how to contour the plexus and you plan on giving feedback that is totally fine. If your goal is to just get work done, and this doesn’t take away from learning, then it is fine too. My issue is when residents have to do it overwhelmingly and receive minimal feedback on anything. This is not uncommon. Hire more people to do this work. Residents are not there for cheap labor.

 

[RickyScott]

Hi, SUNY Upstate resident here. Biases aside, I don't think Upstate makes the list:
1. 100% employment rate in the past 7+ years (including this year)
2. 100% board pass rate in the past 7+ years (even 2 years ago)
3. Get all our requirements in house, no need for away rotations, honestly no stress from this standpoint at all
4. Non-malignant, very responsive PDs and PC
5. Sweet vacation policy
I'm happy to hear other peoples' opinions from the outside.

Here is the harsh reality: having matched several years ago, I am sure your scores/grades/cv etc are much better than applicants matching at top programs today. How (highly accomplished) residents at upstate performed over past 7 years, is in no way representative of the prospects of the losers who will match into your program this year, and how they fare in a job market with no jobs..

 

[metview]

Hi, SUNY Upstate resident here. Biases aside, I don't think Upstate makes the list:
1. 100% employment rate in the past 7+ years (including this year)
2. 100% board pass rate in the past 7+ years (even 2 years ago)
3. Get all our requirements in house, no need for away rotations, honestly no stress from this standpoint at all
4. Non-malignant, very responsive PDs and PC
5. Sweet vacation policy
I'm happy to hear other peoples' opinions from the outside.

This is all likely true and is great, but there are only 90 residency programs in the country and I think we can safely say Upstate is around 60-70/90 which is consistent with that list. Also, I know that you guys SOAPd another specialty reject who had no interest in oncology at all. That type of behavior demonstrates how SUNY upstate values residents (ie. cheap labor for note writing and contouring). Not cool at all because SOAPing people who have ZERO interest in oncology is preventing the market from correcting itself.

 

[medgator]

This is all likely true and is great, but there are only 90 residency programs in the country and I think we can safely say Upstate is around 60-70/90 which is consistent with that list. Also, I know that you guys SOAPd another specialty reject who had no interest in oncology at all. That type of behavior demonstrates how SUNY upstate values residents (ie. cheap labor for note writing and contouring). Not cool at all because SOAPing people who have ZERO interest in oncology is preventing the market from correcting itself.

For awhile, had issues with faculty number at main site as well as double coverage of attendings.

Even if those have improved, In the year 2020, there is no reason for a US MD student to go to a bottom half program. None. There will not be jobs for all the 200 grads coming out in 2025

 

[metview]

Here is the harsh reality: having matched several years ago, I am sure your scores/grades/cv etc are much better than applicants matching at top programs today. How (highly accomplished) residents at upstate performed over past 7 years, is in no way representative of the prospects of the losers who will match into your program this year, and how they fare in a job market with no jobs..

They are a 2, 1, 2, 1 residency. In one of the years in which they were taking only ONE resident, they couldn't match and SOAPd a resident with zero interest in oncology. Imagine what's going to happen this yr.

 

[drewdog1973]

Allegedly, one of the programs on the **** list is considering an MRI linac fellowship. This is getting out of control.

 

[medgator]

Allegedly, one of the programs on the **** list is considering an MRI linac fellowship. This is getting out of control.

Should be as useful as a proton or iort fellowship.

 

[Neuronix]

Allegedly, one of the programs on the **** list is considering an MRI linac fellowship. This is getting out of control.

WashU and UCLA have both had MRI linac fellows to my knowledge, wouldn't be surprised if there are more lurking out there.

 

[elementaryschooleconomics]

Should be as useful as a proton or iort fellowship.

I'm waiting for the Dosimetry fellowship!

 

[medgator]

I'm waiting for the Dosimetry fellowship!

Certainly would help the job search....

 

[RadOncDoc21]

Certainly would help the job search....

This actually makes more sense!

 

[ramsesthenice]

WashU and UCLA have both had MRI linac fellows to my knowledge, wouldn't be surprised if there are more lurking out there.

What in the world does one do during an MR Linac fellowship? I’m being serious. We have one. It’s really not that complicated for the MD. Unless the goal is to find innovative ways of making easy things hard?

 

[medgator]

What in the world does one do during an MR Linac fellowship? I’m being serious. We have one. It’s really not that complicated for the MD. Unless the goal is to find innovative ways of making easy things hard?

What does one do in an "advanced radiation" fellowship? Or a "future of rad onc" fellowship?

For all intents and purposes, rad onc fellowships should be considered unaccredited 💩 and guilty/exploitative until proven useful

 

[Lamount]

What does one do in an "advanced radiation" fellowship? Or a "future of rad onc" fellowship?

I think there should be a “history of rad onc” fellowship where you learn to treat acne and tinea capitis

 

[metallica81788]

Unless the goal is to find innovative ways of making easy things hard?

Another thing that RadOncs have been doing without fellowships for all of eternity

 

[radonc17]

re: contouring normals - if the resident does normal structures it's scut but if the attending does them it's work? i don't think i agree with this - may be because i treat H&N and there is great case to case variability in normal structures that help you define your target volumes so i think they go hand in hand

Not wrong to contour normals as a resident, up to a certain point

Little value in basic contouring ie liver, kidneys, etc

It is def wrong for attendings to expect residents to do everything on their behalf, especially from day 1 (90% of programs)

If you compare to diagnostic radiology residency, those residents don’t read every single case that comes in through the door

it’s a gradual buildup with built in time to study during the day so you know what you are looking for

radonc residency is walk through the door and do everything, despite it being brand new to you, and then do it in timely manner or you’re a bad resident

if we are honest about the specialty, there is def a sense of entitlement amongst some faculty RE resident training/use

 

[medgator]

Not wrong to contour normals as a resident, up to a certain point

Little value in basic contouring ie liver, kidneys, etc

It is def wrong for attendings to expect residents to do everything on their behalf, especially from day 1 (90% of programs)

If you compare to diagnostic radiology residency, those residents don’t read every single case that comes in through the door

it’s a gradual buildup with built in time to study during the day so you know what you are looking for

radonc residency is walk through the door and do everything, despite it being brand new to you, and then do it in timely manner or you’re a bad resident

if we are honest about the specialty, there is def a sense of entitlement amongst some faculty RE resident training/use

Absolutely nailed it

 

[Krukenberg]

Not wrong to contour normals as a resident, up to a certain point

Little value in basic contouring ie liver, kidneys, etc

It is def wrong for attendings to expect residents to do everything on their behalf, especially from day 1 (90% of programs)

If you compare to diagnostic radiology residency, those residents don’t read every single case that comes in through the door

it’s a gradual buildup with built in time to study during the day so you know what you are looking for

radonc residency is walk through the door and do everything, despite it being brand new to you, and then do it in timely manner or you’re a bad resident

if we are honest about the specialty, there is def a sense of entitlement amongst some faculty RE resident training/use

Some faculty, sure. But how are you possibly qualified to speak about the training culture at 90% of programs?

 

[medgator]

Some faculty, sure. But how are you possibly qualified to speak about the training culture at 90% of programs?

General jist. Not sure it's 90% but definitely the majority, could easily be 75%

 

[RadOncDoc21]

General jist. Not sure it's 90% but definitely the majority, could easily be 75%

I guess we should just all blindly believe the program directors.

 

[medgator]

I guess we should just all blindly believe the program directors.

Some of them might even be on this forum!

 

[drewdog1973]

I guess we should just all blindly believe the program directors.

Similar to blindly believing random people. Neither optimal solution.

 

[fiji128]

Not wrong to contour normals as a resident, up to a certain point

Little value in basic contouring ie liver, kidneys, etc

This describes the place where I trained. Old entitled attendings who could not practice without sharp residents doing nearly everything for them. I'm sure they would retire if they had to carry their own services for more then a month without the resident seeing all the clinic patients, all the inpatients, all the contours, all the documentation and keep on top of all the required scunt work to boot.

The acgme knows who these programs are but chooses to shield them rather then just close them down (I guess except for Cornell).

 

[RadOncMegatron]

Allegedly, one of the programs on the **** list is considering an MRI linac fellowship. This is getting out of control.

WashU and UCLA have both had MRI linac fellows to my knowledge, wouldn't be surprised if there are more lurking out there.

NO. Please tell me this is not true. I should open a fellowship too it will be the "Private Practice Fellowship" where you can learn about "real life practice" before you start!

 

[radonc17]

NO. Please tell me this is not true. I should open a fellowship too it will be the "Private Practice Fellowship" where you can learn about "real life practice" before you start!

Unfortunately the “private practice” fellowship already exists

2 publicly posted within the past year that I have in my database

Inova and Baptist Health

 

[radonc17]

Some faculty, sure. But how are you possibly qualified to speak about the training culture at 90% of programs?

We can spend time getting lost in the weeds on exact % or focus on the spirit of the post

 

[RadOncDoc21]

Similar to blindly believing random people. Neither optimal solution.

True but what would the random person’s motive be compared to someone who it would actually effect?

Could I just make up something? Sure, but I guess what would be my motive... to mislead med students... why would I care? Now a PD or chair who is directly involved may care a little more than me... just saying.

I truly believe in the end it won’t matter, good-bad programs will continue to fill up positions with warm bodies.

 

[elementaryschooleconomics]

It is def wrong for attendings to expect residents to do everything on their behalf, especially from day 1 (90% of programs)

This was/is my experience, I was talking with some of my co-residents about this earlier today.

From my first clinic day as a PGY-2 I was expected to solo all consults. I remember asking my attending how long I should spend with the consult, and was looked at like I had 3 heads. The answer I got was "as long as it takes to cover everything, most residents seem to be in there for 30-45 minutes". I was just sent in like a good soldier so my attending could manage a clinic schedule not possible without a resident.

That pretty much set the tone for my training in RadOnc. Thanks, textbooks, eContour, and MedNet!

 

[scarbrtj]

Calling a rad onc fellowship a “fellowship” is way worse than calling forward planned IMRT “IMRT.” Yeah I said it.

 

[thecarbonionangle]

This describes the place where I trained. Old entitled attendings who could not practice without sharp residents doing nearly everything for them. I'm sure they would retire if they had to carry their own services for more then a month without the resident seeing all the clinic patients, all the inpatients, all the contours, all the documentation and keep on top of all the required scunt work to boot.

The acgme knows who these programs are but chooses to shield them rather then just close them down (I guess except for Cornell).

this situation is common and it is not just “old” attendings.

 

[drewdog1973]

this situation is common and it is not just “old” attendings.

Very true.

The Cornell shutdown was led by a courageous resident, now junior attending that put everything on the line. There are very few residents that have the "cojones" (in quotes, b/c resident was a 'she'). She did it publicly, vocally, and during the job search year and into her first year as staff doc. A #radonc hero, in my book. Fomenti still foaming at the mouth and wants retribution, but thankfully will be impotent to do anything.

 

[thecarbonionangle]

Unfortunately the “private practice” fellowship already exists

2 publicly posted within the past year that I have in my database

Inova and Baptist Health

More are in the works. These pp opening up “fellowships” and making attempts at “residencies” for cheap labour will be the last nail in the coffin

 

[evilbooyaa]

Very true.

The Cornell shutdown was led by a courageous resident, now junior attending that put everything on the line. There are very few residents that have the "cojones" (in quotes, b/c resident was a 'she'). She did it publicly, vocally, and during the job search year and into her first year as staff doc. A #radonc hero, in my book. Fomenti still foaming at the mouth and wants retribution, but thankfully will be impotent to do anything.

Details? A movie should be made about this.

 

[thecarbonionangle]

The thing about the cornell situation is that there are many hellpits just like that getting full accreditation year after year, so the system is broken. The burning giant pile of manure that is these places, will never be put out unless the acgme begins closing down many programs. This takes leadership. I know one of former residents may have had the option to end up at msk, not sure if thats what they chose. Most of the cpmc residents ended up at stanford i think so things always end up working out.

Frothing at mouth formenti should never be allowed near a radiation program again and Cornell should never be allowed to reopen. Other NYP programs should be shut down and a better future and education guaranteed for residents. Let cornell go into the history books a a shut down place like Univ of NM, east carolina, george washington, howard, etc.

 

[drewdog1973]

Residents have to be the ones to take the risk. Junior faculty will not. Program directors have to justify their existence. Chairmen/women will act in opposition for the cause.

Programs don't just "shut down".

 

[medgator]

Details? A movie should be made about this.

Agree? @drewdog1973 ?

 

[Lamount]

Not wrong to contour normals as a resident, up to a certain point

Little value in basic contouring ie liver, kidneys, etc

It is def wrong for attendings to expect residents to do everything on their behalf, especially from day 1 (90% of programs)

If you compare to diagnostic radiology residency, those residents don’t read every single case that comes in through the door

it’s a gradual buildup with built in time to study during the day so you know what you are looking for

radonc residency is walk through the door and do everything, despite it being brand new to you, and then do it in timely manner or you’re a bad resident

if we are honest about the specialty, there is def a sense of entitlement amongst some faculty RE resident training/use

So it goes without saying that many people complete a difficult residency convincing themself that working one's a** off is the ONLY way to be well-trained...

However, I also think there is some utility for a resident to FEEL LIKE everything is your responsibility (even if it isn't). You can either learn how to overcome feeling overwhelmed as a resident (when the stakes are low and you have a safety net beneath you), or as an attending.


I don't think it is wrong to demand a lot of a resident (even a junior one) so long as you give a lot in return in terms of teaching, going over contours, and spending time at the end of a long clinic day to let them practice looking at ports.