Small rad onc program...where do I start?

[Datypicalpremed]

Hey - long time lurker on these forums here...

Long story short - had some interest in rad onc for a while. Heck, shadowing rad oncs is what got me to apply to Med school in the first place. Entered Med school. Got seduced by pretty much every other specialty. Went wild. Fast forward 2 years and I'm nearing the end of my required clerkship (surgery) before I start my PhD training. And somehow I've gone full circle and now I'm most interested in rad onc again (mainly though interactions with the rad oncs at tumor boards that the surgical oncologist I follow attends).

My main concern is this:

I come from a mid tier school that has a small rad onc department with no residency program. In fact, it serves as a satalite training site for the residency program from a nearby city. Probably not gonna get a home residency program anytime soon. There are a few big names (at least...on paper), but most of the faculty are adjunct faculty. There is also not a lot of...ahem..."significant" rad onc research going on here either.

Given these conditions, how can I best get involved in the field and become competitive? I'm currently planning to spend much of my clinical hours during my PhD years shadowing the few rad onc attendings who practice here and attending meetings with them like tumor board to build connections. I'm going to be doing basic cancer biology research and am willing to put in the time and effort to get some solid publications. I also believe I have a solid step 1 score (250).

Is this the best I can do at this point? I was thinking about getting more involved with the residency program that uses my home rad onc as a training site...possibly to get some rad onc related research. But I imagine this can get a little complicated, yes?


Also, a somewhat unrelated question:
From what I've read from previous posts, it seems getting solid step 1 scores, research and LORs are most important for getting into rad onc. It also seems clerkship grades are important, but they haven't been emphasized as much (correct me if I'm wrong...)? I ask because I certainly don't expect to honor my surgery rotation and am expecting a HP...maybe a P if I really mess up.


Just how good do your clerkship grades have to be for rad onc? Hypothetically speaking, if one were to get all HPs with maybe 1-2 Hs sprinkled in, and everything else being solid, would that make a strong applicant? Granted, I'm still gonna give it my all, but I just want a good reference.


Thanks!

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[evilbooyaa]

I'm not sure on the importance of clerkship grades. I've heard it's the usual, but things are scrutinized as hard as they may be in other fields. I think all HPs with 1-2 Hs would be reasonable. I got 2 passes, 3HPs, and 1 Honors IIRC when I was a MS3.

I think your best bet would be to look at the residency program that uses your facility as a satellite. As long as it's not an unreasonable drive, you could contact attendings there (with your local attendings' blessings of course) and get involved in research projects. It's generally not too complicated. Projects may move a touch slower, but you have a few years of your PhD to get a few things done. I'd at least look into it if I was in your shoes. Alternatively, if there is some minor research being done at the local facility, that would work too. Get publications with the 'big name' on them.

Otherwise, your PhD work in cancer biology will produce articles that will also count towards your 'required' research total. There are certainly people that have a PhD in cancer biology, no clinical research, that still match in Rad Onc. That number may be going down given the competitiveness, but they still exist. 250 step 1 is obviously a good start.

 

[Datypicalpremed]

I give weight to clerkship grades, and I particularly look at surgery and medicine grades. I can see why some PDs might not. It's tedious to look through transcripts, and med schools make the grading opaque and difficult to compare. They want you to read the MSPE. Good clerkship grades indicate that a student can show up a do the work day after day, month after month, which is what we want in a resident. The clerkship grades usually don't diverge much from board scores. As far as research goes, almost everybody who applies has their name on 2 or 3 abstracts. That's just the baseline these days. 250 on the boards is pretty good. Below about 230, residents seem to struggle on the TXIT and really have work hard for the boards.

Thank you for the perspective! If you don't mind me asking, to what degree would you weigh clerkship grades? For example, if someone were to have HP in medicine and surgery, but was strong in everything else (including scores, research, LORs, MSPE), could you see yourself eventually inviting this applicant for an interview?

I admit I only ask because I recently got the chance to talk to rad onc residents about this and they said programs expect "mostly honors" and for the MPSE to say "outstanding" or "exceptional" - nothing less. But I honestly can't tell if I was just the latest victim in the game of "Scare the Med Student"

 

[evilbooyaa]

Thank you for the perspective! If you don't mind me asking, to what degree would you weigh clerkship grades? For example, if someone were to have HP in medicine and surgery, but was strong in everything else (including scores, research, LORs, MSPE), could you see yourself eventually inviting this applicant for an interview?

I admit I only ask because I recently got the chance to talk to rad onc residents about this and they said programs expect "mostly honors" and for the MPSE to say "outstanding" or "exceptional" - nothing less. But I honestly can't tell if I was just the latest victim in the game of "Scare the Med Student"

As an MS4 quite recently, based on the interviews I got without Honors across the board, I don't think it is a dealbreaker. Certainly helps to have all honors across the board, obviously. PDs can post their own experiences.