The True Enemy

[radoncgrad2019]

everyone needs to stop fighting against each other here and also versus random probably well-meaning normal people who work in academics (most of them probably in academics because they liked the geopgraphic options better in academics)

there IS a true enemy though - and that is people trying to actively expand current programs or are trying to open new programs.

Let's keep this as a place to document these people/places as we become aware of them. They are the problem.

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[FrostyHammer]

I wholeheartedly agree with the post above. I completely agree that residency expansion is truly the core of the problem, but until that is addressed there is no point in dissuading medical students from the field, because what that ends up doing is diluting the field, knowing that the vast majority of programs are going to SOAP at some point or another. I also want to sincerely address to everybody regarding some of this bashing recently. Not all private practitioners are great, not all academics are great. Not all private practitioners are bad, not all academics are bad. There are good and bad people in every "group" one can think of... Every race, every religion, every gender, every type of rad onc practice. So while I think my advice will eventually and inevitably fall on deaf ears, let's seek to be better than this.

 

[xrthopeful]

I also want to sincerely address to everybody regarding some of this bashing recently. Not all private practitioners are great, not all academics are great. Not all private practitioners are bad, not all academics are bad. There are good and bad people in every "group" one can think of

this, this, this, this.

 

[medgator]

Arkansas, U Tenn, WVU, City of Hope, Mayo Scottsdale and LIJ have all opened in the last 3-5 years haven't they?

All part of the problem imo.

 

[deleted1002574]

Does Houston need 7 (MDACC) + 2 (Baylor) residents a year!!!!??

 

[radoncgrad2019]

Does Houston need 7 (MDACC) + 2 (Baylor) residents a year!!!!??

No. Shut down Baylor and cut MDACC down to 5.

 

[utubefan]

Arkansas, U Tenn, WVU, City of Hope, Mayo Scottsdale and LIJ have all opened in the last 3-5 years haven't they?

All part of the problem imo.

I disagree. Why the hate for *all* new programs? (At least one of the above is over 7 years old now, for the record.) Because our grads get good jobs?

I would say that my training from a "newer" program is equal to or even better than some of the more established programs out there.

Med students reading this -- don't be afraid. You'll get good training and a good job coming out of at least one of the above "new" programs (and maybe the others too )

 

[radoncgrad2019]

Ya great idea shut down only place who does charity in our nation’s third largest city while the bully next door tells their poor uninsured illegal patients to just cross the street to get “free” care

Houston isn’t third

Also no one said to shut down the hospital. Just the training program.

 

[medgator]

I disagree. Why the hate for *all* new programs? (At least one of the above is over 7 years old now, for the record.) Because our grads get good jobs?

I would say that my training from a "newer" program is equal to or even better than some of the more established programs out there.

Med students reading this -- don't be afraid. You'll get good training and a good job coming out of at least one of the above "new" programs (and maybe the others too )

Your program has contributed to the overall worsening of the job market as a whole, impacting everyone. Geography was always a difficult needle to thread when we only graduated 120/year. Moreover, there really wasn't a need for your program to begin with.

I personally wouldn't hire someone out of a new vs existing long-standing training program, and I'm sure I'm not the only one. Many of these newish programs probably lack peds/brachy, and who knows, maybe even sbrt and igrt given the plethora of those "Advanced" fellowships that have been popping up the last several years.

If Arkansas, Tennessee and West Virginia needed radiation oncologists, they should have upped the compensation instead of collectively screwing the field

 

[beawareindn]

Your program has contributed to the overall worsening of the job market as a whole, impacting everyone. Geography was always a difficult needle to thread when we only graduated 120/year. Moreover, there really wasn't a need for your program to begin with.

I personally wouldn't hire someone out of a new vs existing long-standing training program, and I'm sure I'm not the only one. Many of these newish programs probably lack peds/brachy, and who knows, maybe even sbrt and igrt given the plethora of those "Advanced" fellowships that have been popping up the last several years.

If Arkansas, Tennessee and West Virginia needed radiation oncologists, they should have upped the compensation instead of collectively screwing the field

Honestly, trainees are in their early to mid 30's when they are spending 4 of their crucial adult life. It is very hard relocate after residency and even with very high compensations people are less likely to move into these areas. I understand the need for some of these programs.

IMO I believe all the programs should come together and say lets cut down the residency spots by 25%. And it should happen proportionally. Programs with 4 totals residents should cut down to 3 and programs with 20 total residents should cut down to 15. I think its a fair way to do it. Unfortunately the people in charge are from big programs...

 

[xrthopeful]

Many of these newish programs probably lack peds/brachy, and who knows, maybe even sbrt and igrt given the plethora of those "Advanced" fellowships that have been popping up the last several years.

lol okay, don't go too far.

 

[DebtRising]

I disagree. Why the hate for *all* new programs? (At least one of the above is over 7 years old now, for the record.) Because our grads get good jobs?

I would say that my training from a "newer" program is equal to or even better than some of the more established programs out there.

Med students reading this -- don't be afraid. You'll get good training and a good job coming out of at least one of the above "new" programs (and maybe the others too )

New programs were created by physicians and administrators who knew we were already training more physicians in rad onc than society needs, and made the judgement it would be more beneficial to their departmental budgets to incorporate resident labor relative to mid-levels.

NYC did not need 2 programs to open in the last 8 years when it has been well served for 20+ years. Smaller programs, such as some of those listed above, are indeed in areas with less physician coverage - but rather than target interested parties or partner up with a larger center to recruit someone for a joint-training to fill said need, opened up new programs for perpetual annual training, blessed by the RRC and ACGME. There is a difference between filling a need for a physician with a 20-30 year career and opening up a program to annually crank out residents.

And for about the 10,000th time, there was publish data we were training too many residents back in 2015, and the general feeling on this was known and openly discussed since 2012. Fellowship openings increased for a reason.

There's no reason to bash or attack anyone, but newer programs are constructed of providers and administrators who knew there was an oversupply issue and decided their department work flow and budget was more important than the fate of future physicians entering this field. And so were a lot of mid-level and big programs that expanded during the same time. But it is a particularly odd vibe to know or at least be confronted with data that there are already too many physicians in this field and start up a whole residency program in the face of that from scratch. That doesn't mean personally those people are bad people, they probably do great compassionate things at work and at home, but yea opening in the face of over-training does say something about the feel of those departments, or at least their professional motivation. Only a touch worse though than the bigger academic programs who both expanded and expanded fellowship offerings to new grads in my book.

 

[evilbooyaa]

Arkansas, U Tenn, WVU, City of Hope, Mayo Scottsdale and LIJ have all opened in the last 3-5 years haven't they?

All part of the problem imo.

Arkansas U Tenn and WVU yes. Neither one of those 3 seems to have graduated a resident yet because of how new they are.
Mayo Arizona I have no idea b/c they don't put that info on the website. It began in 2013 so maybe 1 or 2 grads thus far?
LIJ and City of Hope, same thing can't tell. But I think both of those programs have at least a few graduates (like 3-5) meaning they've been around for at least 7-9 years?

 

[Neuronix]

I disagree. Why the hate for *all* new programs? (At least one of the above is over 7 years old now, for the record.) Because our grads get good jobs?

I would say that my training from a "newer" program is equal to or even better than some of the more established programs out there.

Med students reading this -- don't be afraid. You'll get good training and a good job coming out of at least one of the above "new" programs (and maybe the others too )

This is the crux of the problem. Nobody will agree to which programs should be reduced or cut. The ones trying to form or expand will always make a case as to why they should be the ones to form or expand.

The only one who could potentially put an end to residency overexpansion in my opinion is the ACGME/RRC, though ASTRO could certainly help by taking a stance. Any cuts would probably just have to be across the board since nobody would ever agree to being cut more than the other guys. But none of these groups have shown any ability or willingness to even attempt a residency contraction.

At this point even putting a hard stop to residency expansion seems like a fairy tale.

 

[Mandelin Rain]

The minimum case thing is a laughable hurdle to cross. The fact that you could treat nothing but bone Mets with a few brachytherapy procedures and graduate as a rad onc is ridiculous. Need site based minimums and greatly increased srs/sbrt numbers.

 

[evilbooyaa]

As I (and some others) have said for a while, the way to cause contraction is a sharp increase in the ACGME requirements for a graduating resident, while limiting how many sites a resident can rotate at (so they're not just farmed out to satellites to meet their numbers). This does not 'discriminate' against programs then, it affects those who do not have the numbers to support their current complement of residents. I imagine it will lead to closing of some sub-standard programs and at minimum stabilization, if not contraction, of programs that are above their means.

We should be mandating something like 350 definitive EBRT cases, with site-specific minimums (like 30-50 within each major site of radiation oncoloy). I'd favor something like 150 SRS and 150 SBRT cases per resident minimum. I'd favor 50 intracavitary insertions, at least say 30 of which are tandem based. I'd favor at least 15 interstitial cases, with at least 5 of them being prostate and 5 of them being breast.

I mean we'll see what Vapiwala can do as the head of RRC who at least verbally seems to acknowledge that this is a problem.

*EDIT* - Scooped by Mandelin Rain. Completely agree, obviously.

 

[deleted774703]

Speaking of true enemy. Here is ARRO showing top concerns and then SCAROP (chairs in rad onc) response.

https://www.redjournal.org/article/S0360-3016(19)33454-6/fulltext

DEFINE_ME

 

[RadOncDoc21]

Speaking of true enemy. Here is ARRO showing top concerns and then SCAROP (chairs in rad onc) response.

https://www.redjournal.org/article/S0360-3016(19)33454-6/fulltext

DEFINE_ME

I'm not surprised, obviously there is "nothing to see here." This issue might take years (if that) to resolve with a lot of unhappy people. The job market is tight regardless of what people might lead you to believe. Med students, you have been warned!

 

[OTN]

Let me go ahead and summarize the response:

1. ARRO 'concerns' listed, with the single quotes included. We're not off to a good start.

2. One year board pass rates were bizarrely low. While this negatively impacted the lives of many physicians in training, pass rates are up again, so we'll move on and ignore that we screwed something up.

3. Residency spots - Residency spots have grown in number. We need to "monitor the trend of available positions that exceed residency applicants, and provide feedback to the ACGME. SCAROP stands ready to act in this capacity." Act to do what? Tell the ACGME that applicant numbers have plummeted in radonc? Well...go ahead. Tell them. Now what? Nothing, apparently. That's all. They will let the ACGME know that we're not filling spots. O...k...Done. Thank goodness they're here.

4. Job market - 72% of graduated residents were offered "satisfactory". This is suggested to be a good number, while I think it is too low. ~30% chance of not getting satisfactory job after post-graduate specialty training? They then say "Additionally, the number of job postings on the ASTRO career site, as reported by ARRO, supports the current cohort of graduating trainees. They do not say what the number of job postings is or how they came to the conclusion that it supports the current cohort of growing trainees. They do not address which of those postings are actually for radiation oncologists. They do not address historical trends with respect to the career site.

Finally, the authors, say they "would predict" (well, go ahead and do it, then!) there "should be" a continuing demand for radiation oncologists on the continent, given the aging demographics, the increasing incidence of cancer, and the anticipated retirement of the current generation of Radiation Oncologists. They provide no data to support this statement. They provide no insight into their methodology to help determine how they came to such a conclusion. They are able to make an important declarative statement in our main journal about the demand for our specialty moving forward with zero data and zero acknowledgement about how they came to this conclusion.

Does the Red Journal even have an editorial board? This reads like propaganda rather than scholarship.

 

[scarbrtj]

Finally, the authors, say they "would predict" (well, go ahead and do it, then!) there "should be" a continuing demand for radiation oncologists on the continent, given the aging demographics, the increasing incidence of cancer, and the anticipated retirement of the current generation of Radiation Oncologists. They provide no data to support this statement... Does the Red Journal even have an editorial board? This reads like propaganda rather than scholarship.

Wish they would provide some data. I like to say that cancer incidence is decreasing and physicians are postponing retirement. Heck, re: aging demographics--and if cancer is a disease of the aged--we may actually have less old people around in the future on average. But hey what do I know; not like I'm a RJ reviewer/author/literati.

 

[deleted573262]

Let me go ahead and summarize the response:

1. ARRO 'concerns' listed, with the single quotes included. We're not off to a good start.

2. One year board pass rates were bizarrely low. While this negatively impacted the lives of many physicians in training, pass rates are up again, so we'll move on and ignore that we screwed something up.

3. Residency spots - Residency spots have grown in number. We need to "monitor the trend of available positions that exceed residency applicants, and provide feedback to the ACGME. SCAROP stands ready to act in this capacity." Act to do what? Tell the ACGME that applicant numbers have plummeted in radonc? Well...go ahead. Tell them. Now what? Nothing, apparently. That's all. They will let the ACGME know that we're not filling spots. O...k...Done. Thank goodness they're here.

4. Job market - 72% of graduated residents were offered "satisfactory". This is suggested to be a good number, while I think it is too low. ~30% chance of not getting satisfactory job after post-graduate specialty training? They then say "Additionally, the number of job postings on the ASTRO career site, as reported by ARRO, supports the current cohort of graduating trainees. They do not say what the number of job postings is or how they came to the conclusion that it supports the current cohort of growing trainees. They do not address which of those postings are actually for radiation oncologists. They do not address historical trends with respect to the career site.

Finally, the authors, say they "would predict" (well, go ahead and do it, then!) there "should be" a continuing demand for radiation oncologists on the continent, given the aging demographics, the increasing incidence of cancer, and the anticipated retirement of the current generation of Radiation Oncologists. They provide no data to support this statement. They provide no insight into their methodology to help determine how they came to such a conclusion. They are able to make an important declarative statement in our main journal about the demand for our specialty moving forward with zero data and zero acknowledgement about how they came to this conclusion.

Does the Red Journal even have an editorial board? This reads like propaganda rather than scholarship.

Dear ARRO:
Let's work out a good deal! You don't want to be responsible for slaughtering thousands of careers, and I don't want that either. I've already given you a little sample with respect to recent residency expansion.

I have worked hard to solve some of your problems. Don't let the world down. You can make a great deal. ASTRO is willing to make great deal. We are willing to send information to ACGME. I am confidentially enclosing a copy of these data about the smaller number of students applying for the field, just received.

History will look upon you favorably if you get this done the right and humane way. It will look upon you forever as the devil if good things don't happen. Don't be a tough guy. Be a resident. Don't be a fool!

I will call you later.

Read President Trump’s Bizarre Letter to Turkey’s President

“Don’t be a tough guy. Don’t be a fool!”

nymag.com

 

[fiji128]

I appreciate the ARRO editorial, it is well written and address our major concerns both thoughtfully and professionally.

The SCAROP (Society of Chairmen of Academic Radiation Oncology) response is rambling and shows little understanding/appreciation of whats going on and is overall poorly written. If that response is reflective of the collective thought of this group of "leaders" they need to retire and move on to something else. Quote from SCAROP

"yet opportunities for obtaining jobs appear positive based on the ARRO Data that identified that 72% of graduating residents were offered satisfactory positions, and 88% of Chief Residents obtained their ‘first choice job type’ (1). Additionally, the number of job postings on the ASTRO career site, as reported by ARRO, supports the current cohort of graduating trainees. As we move forward, we need to continuously assess the quality and quantity of the job market, and be prepared to offer opinions on how best to address this issue."

Just wow on so many levels. While probably not intentional, the SCAROP response is basically telling any prospective applicants to run from this field. Just wow again.

 

[medgator]

Lots of denial and bubble living over in the RJ.

Until we see a contraction in spots to <150, I wouldn't touch this field as a medical student. If we get another repeat like the last match, hopefully many of these programs will just self select out themselves

 

[scarbrtj]

I appreciate the ARRO editorial, it is well written and address our major concerns both thoughtfully and professionally.

The SCAROP (Society of Chairmen of Academic Radiation Oncology) response is rambling and shows little understanding/appreciation of whats going on and is overall poorly written. If that response is reflective of the collective thought of this group of "leaders" they need to retire and move on to something else. Quote from SCAROP

"yet opportunities for obtaining jobs appear positive based on the ARRO Data that identified that 72% of graduating residents were offered satisfactory positions, and 88% of Chief Residents obtained their ‘first choice job type’ (1). Additionally, the number of job postings on the ASTRO career site, as reported by ARRO, supports the current cohort of graduating trainees. As we move forward, we need to continuously assess the quality and quantity of the job market, and be prepared to offer opinions on how best to address this issue."

Just wow on so many levels. While probably not intentional, the SCAROP response is basically telling any prospective applicants to run from this field. Just wow again.

 

[RickyScott]

I appreciate the ARRO editorial, it is well written and address our major concerns both thoughtfully and professionally.

The SCAROP (Society of Chairmen of Academic Radiation Oncology) response is rambling and shows little understanding/appreciation of whats going on and is overall poorly written. If that response is reflective of the collective thought of this group of "leaders" they need to retire and move on to something else. Quote from SCAROP

"yet opportunities for obtaining jobs appear positive based on the ARRO Data that identified that 72% of graduating residents were offered satisfactory positions, and 88% of Chief Residents obtained their ‘first choice job type’ (1). Additionally, the number of job postings on the ASTRO career site, as reported by ARRO, supports the current cohort of graduating trainees. As we move forward, we need to continuously assess the quality and quantity of the job market, and be prepared to offer opinions on how best to address this issue."

Just wow on so many levels. While probably not intentional, the SCAROP response is basically telling any prospective applicants to run from this field. Just wow again.

As long as chairs/programs flat out mislead medstudents, I feel compelled to post here. If it happened in pathology, it can happen to us.

 

[Mandelin Rain]

The appropriate term is 'concern'.

We will not acknowledge that residents' concerns are actual concerns so they will be known as 'concerns'.

Welcome to life under an academic chairman. Unfortunately, there aren't many other options in Rad Onc..... and that's a bad thing?

 

[RickyScott]

Truthfully, this kind of editorial is what opens up space and legitimacy for SDN. What a contrast with the emergency medicine professional society.

 

[winstonfoot5]

Why is a Canadian writing about the US job market?
What does this have to do with "burnout"?
"mandate that RO be an integral component of this decision process" what "decision process"?
"Acute changes in the field" Does "acute" mean over the last 20 years?
"RO has been built on the foundation of a pedigree of fabulous and talented individuals" Uh? This is contradicted later
"While ARROs concerns are real" uh...
What "social media event" are they talking about?
"have fueled and perhaps contributed" huh?
"prediction never came true" - past performance is not indicative of future results
"productivelity" - what? covfefe?
"As the specialty changes, as it will, we need the engagement of our future leaders to guide us in a meaningful direction. Making today’s challenges into future opportunities is what is so dynamic and exciting about what we do as a specialty, every day." ah, i feel much better
Very odd article.
i predict a retraction.

 

[Mandelin Rain]

i predict a retraction.

Nah, self awareness would be required.

Those guys read that comment and just thought, "Nailed it!"

It's more a shame that the Red Journal published it as is.

 

[scarbrtj]

Many disconnects here. However in the spirit of keeping the main thing the main thing:

HOW MANY RADIATION ONCOLOGISTS ARE THERE.

According to the Red Journal/SCAROP in 2019: "In a specialty with just over 4,000 practicing physicians in the United States however, it needs to be recognized that in any given year, the market for jobs in certain cities will fluctuate."

But in 2015, ASTRO said there were 5,000 practicing radiation oncologists in the US. (Hint: there are more now.)

If they're gonna be off by ~25% in their number-of-rad-oncs estimate, angels and ministers of grace defend us. They would probably fail ya if you said you'd give 75/37 for Stage III lung on the boards (~25% off from 60/30)... don't know why this article is not a fail for that right there.

 

[OTN]

So many things wrong it's hard to know where to start. However, the Princess-Margaret-affiliated author being a part of the response is super, super bizarre. Of ALL the radiation oncologists available to write an editorial addressing the residents' concerns with respect to the match, they include someone whose program isn't even in the match and never will be? What's going on here? On what planet does that make sense?

 

[Mandelin Rain]

So many things wrong it's hard to know where to start. However, the Princess-Margaret-affiliated author being a part of the response is super, super bizarre. Of ALL the radiation oncologists available to write an editorial addressing the residents' concerns with respect to the match, they include someone whose program isn't even in the match and never will be? What's going on here? On what planet does that make sense?

The Canadian market was always so robust that no resident ever had to do a fellowship or flee the country to find a paying job.... trust me, I'm a SCAROP.

 

[GapCalc]

ARRO: Solid. I’ve been impressed with the tightrope these folks have walked over the last few years.

SCAROP reply: <dumpsterfire.gif>

 

[KHE88]

Was the author of the SCAROP letter drunk? Basic punctuation mistakes. Factually incorrect information.
Wow.

There are unfortunately a lot of self-aggrandizing narcissists and, in a select few cases, I would go as far to say even sociopaths, occupying leadership positions in radiation oncology. They only hear what they want to hear because the world revolves around them.

They've brainwashed many residents to just accepting this shift away from private practices to "institutionalized" employment of physicians as a good thing. They hate on the few PP holdouts, refuse to address the rural undersupply problem in the field, that they don't care about because it's not New York City, and unfortunately many don't care about their employment prospects. Cheap labor to staff satellites and funnel money back to the academic mothership to support so-called "academics" and "researchers" who exclusively publish biased and politically charged articles about "diversity."

NEW RULE: All residents must receive >90% of their cases at the main institution. No more residents in satellites and using that as an excuse to expand residencies. Of course, SCAROP will oppose this. Because it's only about them, not the rest of us, the patients, practice-changing research, or anything else.

 

[deleted1002574]

Agree. All signs point towards inebriation.

 

[thecarbonionangle]

Wish i could say we could blame it on the devil’s juice or the devil’s weed. I think far more sinister process is at play here folks. People did not take their memantine. These are sick people. Now the Canadians are involved? Wtf?. ..The Field is passing them by. Its an embarrassment they thought that was a well written piece.
Im looking forward to the match. Another year of UPMC not matching (hilarious), seeing KO’s program not match. Very funny stuff coming up. I am already gleefully bathing in the mud licking my paws.

 

[JustAdocInBox]

I am encouraged that at least the issue of overexpansion is being recognized, but I am very doubtful it will be sufficiently addressed (cutting back spots to 100-120 or something like that- I just dont see how that can collectively be done) and even so, the waters have been poisoned for 10-15 years minimum as Michael Steinberg said at ASTRO. Lets remember the single most important factor for selecting a job is geography to most residents last year not salary and this is not going to be fixed anytime within the present generation. (I am not sure Ralph gets the geography part)


https://www.merritthawkins.com/uplo..._Final_Year_Medical_Residents_Survey_2019.pdf

Does Houston need 7 (MDACC) + 2 (Baylor) residents a year!!!!??

No. Shut down Baylor and cut MDACC down to 5.

MDACC is cutting back from 7 spots to 6 spots this year and for the foreseeable future.

 

[deleted1002574]

That’s stepping up. Let’s see if anyone else will make similar power moves.

 

[winstonfoot5]

MDACC is cutting back from 7 spots to 6 spots this year and for the foreseeable future.

before the snarky comments come (and they will) we should applaud and encourage this move and this declaration. Medical students take note, here is a program that values resident education. In a year where the applicant enters a "buyers market" you should like what MDACC is selling

 

[RadOncDoc21]

before the snarky comments come (and they will) we should applaud and encourage this move and this declaration. Medical students take note, here is a program that values resident education. In a year where the applicant enters a "buyers market" you should like what MDACC is selling

I’m usually the first to make snarky comments but even I can’t be mad at this. Let’s just hope other programs follow the “MDACC way!” I’m sure someone has already started working on a retrospective review for this move (ok there was one snarky comment).

 

[medgator]

before the snarky comments come (and they will) we should applaud and encourage this move and this declaration. Medical students take note, here is a program that values resident education. In a year where the applicant enters a "buyers market" you should like what MDACC is selling

Agree. Hopefully programs that cut back spots can be recognized on the interview trail and match lists, while those that were created in the last few years don't fill/match.

A few years of that and we may actually start to get back to a place where this field needs to go

 

[radoncgrad2019]

Attention medical students - other than the big 3 in Harvard, MDACC, and MSKCC - other programs that I know for a fact give you a fantastic resident experience and where residents are treated well are WashU, Cleveland Clinic, and Yale.

Agree that this is a HUGE buyer's market for residents, and there are many many many good applicants this year who will be able to snag a really nice residency spot - pay attention to these programs IMO.

 

[deleted774703]

Attention medical students - other than the big 3 in Harvard, MDACC, and MSKCC - other programs that I know for a fact give you a fantastic resident experience and where residents are treated well are WashU, Cleveland Clinic, and Yale.

Agree that this is a HUGE buyer's market for residents, and there are many many many good applicants this year who will be able to snag a really nice residency spot - pay attention to these programs IMO.

Yale treats you well, but a clinically poor program. On interview day they said they barely see any patients. Just sit behind computers and crank out NCDB garbage

 

[RadOncG]

"Additionally, the number of job postings on the ASTRO career site, as reported by ARRO, supports the current cohort of graduating trainees. They do not say what the number of job postings is or how they came to the conclusion that it supports the current cohort of growing trainees. They do not address which of those postings are actually for radiation oncologists. They do not address historical trends with respect to the career site.

Additionally, the number of job postings on the ASTRO career site, as reported by ARRO, supports the current cohort of graduating trainees. As we move forward, we need to continuously assess the quality and quantity of the job market, and be prepared to offer opinions on how best to address this issue."

SCABIES (rad onc chair committee) must have done their own analysis showing that the 219 jobs posted to ASTRO in 2018 were all looking for new graduates with a start date that aligns with graduation.

 

[radoncgrad2019]

Yale treats you well, but a clinically poor program. On interview day they said they barely see any patients. Just sit behind computers and crank out NCDB garbage

I do agree and haveheard the same that the clinical experience isn’t as good.

Cleveland Clinic and WashU I’ve heard are amazing

 

[deleted774703]

I do agree and haveheard the same that the clinical experience isn’t as good.

Cleveland Clinic and WashU I’ve heard are amazing

If you’re looking for a truly great place to go then consider U of Chicago

 

[Neuronix]

There's this weird dichotomy I've run into. There are programs with strong clinical training, but the residents have to work hard and sometimes are unhappy about it. There are programs with weak clinical training, but the residents don't work hard and are pretty happy.

Which is the right type of program?

Here at SDN the mantra has always been "NO DOUBLE COVERAGE RAH RAH RAH", ok but what happens when you're in clinic with attendings who are in clinic like 2 days a week? You only work 2 days a week? Oddly enough, I've seen several programs now where the answer is yes. Clinic 2 days a week, then read or research or contour or go to the beach the other days. I'm sure you're happy with that, but are you actually getting well trained? Also, will the more clinical attendings want to go to bat for you for research and jobs when they are working way harder than you are as a resident?

Just putting it out there. I don't know that there's a right answer. The programs in the past few posts fit into both ends of the spectrum. Nowadays resident evals are taken very seriously at many places, especially with the drop in rad onc matches, so there's an increasing number of opportunities to take it easy during residency to the possible detriment of your career.

 

[deleted774703]

There's this weird dichotomy I've run into. There are programs with strong clinical training, but the residents have to work hard and sometimes are unhappy about it. There are programs with weak clinical training, but the residents don't work hard and are pretty happy.

Which is the right type of program?

Here at SDN the mantra has always been "NO DOUBLE COVERAGE RAH RAH RAH", ok but what happens when you're in clinic with attendings who are in clinic like 2 days a week? You only work 2 days a week? Oddly enough, I've seen several programs now where the answer is yes. Clinic 2 days a week, then read or research or contour or go to the beach the other days. I'm sure you're happy with that, but are you actually getting well trained? Also, will the more clinical attendings want to go to bat for you for research and jobs when they are working way harder than you are as a resident?

Just putting it out there. I don't know that there's a right answer. The programs posted in the past through posts fit into both ends of the spectrum. Nowadays resident evals are taken very seriously at many places, especially with the drop in rad onc matches, so thee's an increasing number of opportunities to take it easy during residency to the possible detriment of your career.

Need to bring out the real program evaluation threads like before

The misuse of the SDN spreadsheet has unintentionally ruined things

Even have loser academics trying to mine the data, but then complain about SDN

Straight up losers

 

[deleted1002574]

Beaumont used to be high volume, hard work, high level of education, but it was a 7 to 6 day before studying and research. People don’t really like that any more. Hopkins residents appear to be treated well, but gosh they sure have a lot of “academic” time for being residents. UPMC has high volumes and one good educator, but you could literally do nothing for 4 years if you wanted to. The quality varies so widely now. Probably like derm, too, lot of crap programs, but motivated high quality residents who could teach themselves. When the quality falls, and a ortho - wannabe has to learn the CN nerve root paths on CT axials, they just may not get there. The metric will be oral boards 4-5 years from now.

 

[Neuronix]

Orals are easy to pass. Just study hard and memorize scripts. Doesn't make you a good doc though.

Need to bring out the real program evaluation threads like before

The SDN spreadsheet has unintentionally ruined things

It is NOT the SDN spreadsheet. We wrote a whole letter to the editor about this!!! https://www.redjournal.org/article/S0360-3016(19)30792-8/fulltext

I agree with you 100%. I have advocated multiple times to delink that spreadsheet from SDN entirely, though we are an organization who works through committee and not everyone agrees with me.

The applicants want the spreadsheet because they don't have to make an SDN account, don't have to login, and the info is very transient so they feel it protects their anonymity better especially in future years since it probably won't hang around in any meaningful way.

But not having the info out there in a moderated, systematic, and semi-permanent way hinders our ability to get quality information out there. Anyway, people vote with their feet. EB and I have asked numerous times to get more reviews in the sticky thread or PM to us to post anonymously, and almost nobody takes us up on the offer.