VVPN Livestream 7PM EST, "What Did We Learn from 2021 Match?"

[elementaryschooleconomics]

1) This channels the "opening to a crime-thriller documentary on Netflix" perfectly

2) I find it hilarious what is created when you enrich a population (RadOnc) with some of the highest achieving medical students of their generation, and then force them to watch, while trapped in their residency training or early-to-mid career jobs, as the specialty which almost mandated a 250+ Step 1 score just absolutely blows up around them

To the few people left on the wrong side of this debate:

---

Members don't see this ad.

 

[RadOncDoc21]

I’ll need Actions... not words!

 

[RadOncDoc21]

This was great!

 

[medgator]

That's fantastic

 

[FrostyHammer]

Rahul Tendulkar. Also seemed to understand whats going

^ Initial impression

^ Reality

 

[CurbYourExpectations]

^ Initial impression


^ Reality

I don’t think they have cut spots, but talk about the issues a lot. Large majority of programs need to alternate 1 and 2 residents a year to make a real difference.

 

[Radonc90]

So far it is just talks and talks (a good start btw).

The most difficult part is the action, and yes programs have to close/cut spots.
This. Is. Unsustainable.

 

[Neuronix]

I don’t think they have cut spots, but talk about the issues a lot. Large majority of programs need to alternate 1 and 2 residents a year to make a real difference.

No, they haven't. If you're going to be a program director taking the side of oversupply, you have to make action, not words. Politics and CV buffing with talks and papers is not what will fix this issue.

 

[deleted573262]

No, they haven't. If you're going to be a program director taking the side of oversupply, you have to make action, not words. Politics and CV buffing with talks and papers is not what will fix this issue.

MDA and Colorado have cut spots. They walk the walk.

 

[metallica81788]

Nobody wants to be the PD or chair to sit out the match for 2-3 years. That's what it will take to actually move the needle in the right direction - there needs to be a national consensus agreement. The programs that need to disappear won't do it. Best case scenario those unnecessary or bad programs will view it as "why should I make my life harder when it won't actually change anything, continue SOAPing note writers!"

Cutting one or two spots here or there is noble, but that's only about 10 programs. It doesn't actually do anything.

[Insert any variation of tiny excavator trying to release the Suez canal ship]

 

[seper]

Did not watch the stream, but it must be intimidating to debate someone whose salary is 3 times yours

 

[MegaVoltagePhoton]

Did not watch the stream, but it must be intimidating to debate someone whose salary is 3 times yours

Not if his iq is 1/3 of those he is debating (based on his actions, words, and era in which he matched)

 

[RickyScott]

Not if his iq is 1/3 of those he is debating (based on his actions, words, and era in which he matched)

I was thinking something along those lines when he said:
“its interesting to think that medical students who have no idea about radiation oncology know what the future is going to hold by walking with their feet, and if they are that smart, shame on us!”

 

[Radonc90]

Agree,

- I said this before and I will say it again. Many moons ago, I did a Nephrology elective as an M3. I loved it (acid-base balance, electrolytes management, glomerulonephritis pts, understanding the difficulty of dialysis pts). I never became a Nephrologist. The Nephrologist never ever tried to sell me Nephrology as a "dream job". He was a fantastic Nephrologist (world-renowned btw), to this day, I still love him, great teacher, I learned a lot.

- So why can't we be like this "Nephrologist"? Just teach M3, M4 students normally. Teach them what they need to know about oncology, whether they become PCP, surgeon or radiologist. Out of 100 students doing electives in radonc, roughly 3-5% (in my experience) decide to go into radonc, this is great, tell them honestly:

1. "This is a great field, you will do well in this field."
2. Job market is an issue, do your own research and make an informed decision.

- That is all we have to do.

- The issue of oversupply has been discussed to death here. The ONLY solution is program contraction/closure, no other way around it.

- "Great field" or not: it is in the eyes of the beholders. The surgeons think their field is the greatest. My pathologist friend told me he loves Path to death. So there you go.

PS: This leads to an interesting question: for those of you attendings or PGY-4's and PGY-5s, if you have to do it all over again, what specialty would you go into in 2021?

 

[RickyScott]

Agree,

- I said this before and I will say it again. Many moons ago, I did a Nephrology elective as an M3. I loved it (acid-base balance, electrolytes management, glomerulonephritis pts, understanding the difficulty of dialysis pts). I never became a Nephrologist. The Nephrologist never ever tried to sell me Nephrology as a "dream job". He was a fantastic Nephrologist (world-renowned btw), to this day, I still love him, great teacher, I learned a lot.

- So why can't we be like this "Nephrologist"? Just teach M3, M4 students normally. Teach them what they need to know about oncology, whether they become PCP, surgeon or radiologist. Out of 100 students do electives in radonc, roughly 3-5% (in my experience) decide to go into radonc, this is great, tell them honestly:

1. "This is a great field, you will do well in this field."
2. Job market is an issue, do your own research and make an informed decision.

- That is all we have to do.

- The issue of oversupply has been discussed to death here. The ONLY solution is program contraction/closure, no other way around it.

- "Great field" or not: it is in the eyes of the beholders. The surgeons think their field is the greatest. My pathologist friend told me he loves Path to death. So there you go.

PS: This leads to an interesting question: for those of you attendings or PGY-4's and PGY-5s, if you have to do it all over again, what specialty would you go into in 2021?

I honestly believe most of this years match class will not be attendings in radonc in 5 years (would love to make a bet on this); would be crazy to put yourself in that position.

 

[Radonc90]

I honestly believe most of this years match class will not be attendings in radonc in 5 years (would love to make a bet on this); would be crazy to put yourself in that position.

Just curious, do you think the 2026 grads (people that are matched in March 2021) will graduate in 2026 and drive Uber to make a living (sorry about the Uber joke)?

 

[RadOncMegatron]

I honestly believe most of this years match class will not be attendings in radonc in 5 years (would love to make a bet on this); would be crazy to put yourself in that position.

I think that’s a little high, but would say 20% fellowship or underemployed (part time or locums). Bottom line it’s going to be ugly.

 

[RickyScott]

Just curious, do you think the 2026 grads (people that are matched in March 2021) will graduate in 2026 and drive Uber to make a living (sorry about the Uber joke)?

I think quite a few will be in fellowships and some will switch specialties during training. Will also be some involuntarily part time.

 

[radonc17]

Agree,

- I said this before and I will say it again. Many moons ago, I did a Nephrology elective as an M3. I loved it (acid-base balance, electrolytes management, glomerulonephritis pts, understanding the difficulty of dialysis pts). I never became a Nephrologist. The Nephrologist never ever tried to sell me Nephrology as a "dream job". He was a fantastic Nephrologist (world-renowned btw), to this day, I still love him, great teacher, I learned a lot.

- So why can't we be like this "Nephrologist"? Just teach M3, M4 students normally. Teach them what they need to know about oncology, whether they become PCP, surgeon or radiologist. Out of 100 students doing electives in radonc, roughly 3-5% (in my experience) decide to go into radonc, this is great, tell them honestly:

1. "This is a great field, you will do well in this field."
2. Job market is an issue, do your own research and make an informed decision.

- That is all we have to do.

- The issue of oversupply has been discussed to death here. The ONLY solution is program contraction/closure, no other way around it.

- "Great field" or not: it is in the eyes of the beholders. The surgeons think their field is the greatest. My pathologist friend told me he loves Path to death. So there you go.

PS: This leads to an interesting question: for those of you attendings or PGY-4's and PGY-5s, if you have to do it all over again, what specialty would you go into in 2021?

so well said

what do ppl think is the reason so many in our field are desperate to have students apply?

(outside of the ppl who have clear COI)

 

[RickyScott]

so well said

what do ppl think is the reason so many in our field are desperate to have students apply?

(outside of the ppl who have clear COI)

psychological considerations: being a mentor/teacher/leave your mark/treatment philosophy on how others approach oncology. Having a captive audience of admirers. Also, need them for departmental status and writing lots of papers. (When I was rotating through md Anderson years ago, I remember someone criticizing perez for being overpublished, having something like 150 papers at the time; today that would be nothing

 

[seper]

The best force is to have a whistleblower complaint to CMS that these programs, such as WVU, are committing Medicare fraud by using residency slots for a field with no demand from the population, and adequate staffing for decades. But not all slots are Medicare funded.

Another is to bring to attention the lax requirements of our residency completion by the ACGME and make them a party to a medical malpractice lawsuit. But these are hard to find and personal, and would likely involve judgement.

Otherwise, WVU’s gonna WVU and you can see how much support we get from ASTRO. The amount of programs that SOAP this year and last year shows the “leaders” would rather have people with no draw to cancer care or inability to get in other specialities as up to 25% of our graduating class. And no individual should be made to feel shame here or singled out - but some gal/guy who woke up and was like “man I didn’t get OB, maybe FM or rad onc” should be supported? What was the value of our work? What was the value of screening to see who would be good in cancer care? Or research / physics driven?

Agree,

- I said this before and I will say it again. Many moons ago, I did a Nephrology elective as an M3. I loved it (acid-base balance, electrolytes management, glomerulonephritis pts, understanding the difficulty of dialysis pts). I never became a Nephrologist. The Nephrologist never ever tried to sell me Nephrology as a "dream job". He was a fantastic Nephrologist (world-renowned btw), to this day, I still love him, great teacher, I learned a lot.

- So why can't we be like this "Nephrologist"? Just teach M3, M4 students normally. Teach them what they need to know about oncology, whether they become PCP, surgeon or radiologist. Out of 100 students doing electives in radonc, roughly 3-5% (in my experience) decide to go into radonc, this is great, tell them honestly:

1. "This is a great field, you will do well in this field."
2. Job market is an issue, do your own research and make an informed decision.

- That is all we have to do.

- The issue of oversupply has been discussed to death here. The ONLY solution is program contraction/closure, no other way around it.

- "Great field" or not: it is in the eyes of the beholders. The surgeons think their field is the greatest. My pathologist friend told me he loves Path to death. So there you go.

PS: This leads to an interesting question: for those of you attendings or PGY-4's and PGY-5s, if you have to do it all over again, what specialty would you go into in 2021?

I'd do IM. Can either be a hospitalist, a PCP, or sub-specialize via fellowship

 

[Chartreuse Wombat]

so well said

what do ppl think is the reason so many in our field are desperate to have students apply?

(outside of the ppl who have clear COI)

Membership organizations rely on growth.

 

[RickyScott]

Membership organizations rely on growth.

And ponzi schemes

 

[medgator]

Membership organizations rely on growth.

Path forum suggests a similar reason for expansion in their field in face of clear evidence against it... Would definitely make sense

 

[elementaryschooleconomics]

psychological considerations: being a mentor/teacher/leave your mark/treatment philosophy on how others approach oncology. Having a captive audience of admirers. Also, need them for departmental status and writing lots of papers. (When I was rotating through md Anderson years ago, I remember someone criticizing perez for being overpublished, having something like 150 papers at the time.

Strongly agree with this. I was recently reading an opinion piece by a Radiologist who used to be an oral board examiner (before Diagnostic Radiology eliminated orals in 2013). He explained how examiners used to bring their favorite personal cases to give to examinees whom they had already determined would pass their section. He said the first time he brought in a particular zebra case, absolutely no one got it right, and within 3 years of him using this case, everyone got it right, meaning word had gotten back to trainees about what they should prepare for. He said he enjoyed feeling like he "contributed to the fund of knowledge of a generation of Radiologists". The hubris of that is astounding.

But, that's something all academic faculty with residents can enjoy. Every faculty member in my department has their personal practice patterns which they force me to conform to (even if I don't agree). I'm sure it's an ego kick to mold dozens and dozens of residents to your will over the course of your career.

Beyond that, we can never underestimate the lure of prestige in medicine. For the past 20 years, RadOnc has been considered an "elite" specialty. Even if you weren't at the most prestigious institution, well, you were still a Radiation Oncologist! A RadOnc at the worst institution must be "better" than a Family Medicine doc at the best institution, right?

People form identities around that. Now, that personal and professional "elite" identity has been shattered, and recruiting students into the field is a natural defense mechanism.

Everyone wants to be wanted.

 

[medgator]

And ponzi schemes

Someone let me know when theres a 3x inverse ETF for rad onc..... Would've been long it for years

 

[radonc17]

Membership organizations rely on growth.

@Chartreuse Wombat - you’re right, that makes sense from organizational standpoint

I just don’t understand the individual early to mid career attendings (non PDs) who seem to be pushing the message that “we need more students”

My view is if ppl don’t want to join the field then let them be, It’s their life

I’m trying to wrap my mind around it lol

@elementaryschooleconomics - well said above

 

[CurbYourExpectations]

@Chartreuse Wombat - you’re right, that makes sense from organizational standpoint

I just don’t understand the individual early to mid career attendings (non PDs) who seem to be pushing the message that “we need more students”

My view is if ppl don’t want to join the field then let them be, It’s their life

I’m trying to wrap my mind around it lol

@elementaryschooleconomics - well said above

Yeah, I wonder this as well. People that will encourage new people to go in to the field on social media who never considered it or those that will say things to the tune of people they know are getting jobs right now.

Do they not realize that the whole concern is the future of the field? There is a 5 year lag with 1000 people entering the work force. THAT IS ~20% of current RadOncs, without any sign that there is an increased demand and job openings. If that rate continues there will be 7000 radoncs in the USA, unfortunately there is a decreasing demand with less people getting radiation and RadOncs will be able to treat more patients as a result of hypofractionation. All signs pointing towards less jobs, not more. So... what is the gain?

To encourage someone with options and loads of debt to go into a field with the most uncertain future, unless they are extremely interested in RadOnc in general is a little concerning. It is a tough sell to be in a lot of debt as a US medical student and to go into the field with the least certainty in the future. Half of the field is mad at the other half of the field, is this the case in any other specialty?

I hope things work out and everyone gets jobs in a place where they can find happiness, but... what if they can't? What if a lot of people can't? What if some people start going unemployed and can't get back into residency because they are now >5 years out of medical school? What if the people you are trying to entice into a field that they previously had no interest in are now unemployed and >200k in debt? Is that okay?

Fix the issues, educate the students about everything (positives and negatives), and then encourage them to join the field. In that order. These are real people, the residents in training are real people, the young attendings are real people. It does no help to patients to have an oversupply and unemployed doctors with loads of debt.

Yes, treating patients with cancer is a true honor, and it is an interesting field. We all agree on this, literally everyone, even the biggest troll on twitter/sdn/reddit/google docs.

 

[randomname2018]

"We need more students" is a Ken Olivier-esque form of double speak.

It says something and nothing simultaneously. It is an attempt to appease both sides of the argument, while personally assuming no opinion at all. It is an attempt to stand on the side lines until it's clear which side wins.

 

[medgator]

 

[Chartreuse Wombat]

@Chartreuse Wombat - you’re right, that makes sense from organizational standpoint

I just don’t understand the individual early to mid career attendings (non PDs) who seem to be pushing the message that “we need more students”

My view is if ppl don’t want to join the field then let them be, It’s their life

I’m trying to wrap my mind around it lol

@elementaryschooleconomics - well said above

My explanation is ignorance and denial. Many have not considered the implications of overtraining (i.e. lower salaries). I was PD for >15 years at two programs and every year I asked the residents if they wanted more residents in the program. Every year the majority said yes. I held the complement steady but I eventually couldn't convince the faculty that growth was a bad thing and I stepped down and the complement increased. I have not worked with a resident on my service in more than 3 years. My meager contribution to trying to slow growth.

 

[Lamount]

Strongly agree with this. I was recently reading an opinion piece by a Radiologist who used to be an oral board examiner (before Diagnostic Radiology eliminated orals in 2013). He explained how examiners used to bring their favorite personal cases to give to examinees whom they had already determined would pass their section. He said the first time he brought in a particular zebra case, absolutely no one got it right, and within 3 years of him using this case, everyone got it right, meaning word had gotten back to trainees about what they should prepare for. He said he enjoyed feeling like he "contributed to the fund of knowledge of a generation of Radiologists". The hubris of that is astounding.

But, that's something all academic faculty with residents can enjoy. Every faculty member in my department has their personal practice patterns which they force me to conform to (even if I don't agree). I'm sure it's an ego kick to mold dozens and dozens of residents to your will over the course of your career.

Beyond that, we can never underestimate the lure of prestige in medicine. For the past 20 years, RadOnc has been considered an "elite" specialty. Even if you weren't at the most prestigious institution, well, you were still a Radiation Oncologist! A RadOnc at the worst institution must be "better" than a Family Medicine doc at the best institution, right?

People form identities around that. Now, that personal and professional "elite" identity has been shattered, and recruiting students into the field is a natural defense mechanism.

Everyone wants to be wanted.

It’s this same ‘arrogance’ that inspires some of us to have children...
... but presumably, we can afford to feed them

 

[elementaryschooleconomics]

It’s this same ‘arrogance’ that inspires some of us to have children...
... but presumably, we can afford to feed them

Not me, my kids are replacement parts!

 

[TheWallnerus]

Not me, my kids are replacement parts!

View attachment 334169

Also yet another wonderful re-issue in glorious 4K HDR. Which I watched over the weekend as we at the ABR tried to shut down this SDN thing. Curses! Foiled again!

 

[Ray D. Ayshun]

The response to this live stream made me think of a new word, which was already defined on urban dictionary

Urban Dictionary: Twitoris

Any news item or public event, no matter how small or hard to find, that arouses a sudden and significant level of excitement from the Twitter community.

www.urbandictionary.com

In any case, wombat was right, this was the jump the shark moment. This was a last grasp at relevance for competent med students, and unless the cast gets changed, it's cancellation. It's not don't worry about what social media are saying, they're responding to what you're doing. It's, don't worry about what social media are saying because you don't have to. As Ray Zalinsky said, "Great, you've pinpointed it. Step 2 is washing it off."

 

[radonctoent]

I wanted to add my opinion as a med student who was interested in Rad Onc but switched to ENT (and matched). If you can be successful in med school (like prev RO matriculants) you have the capacity to do some literally cursory research into the field. It’s really not that hard to verify the claims on here so not sure where this pearl clutching is coming from.

I spent a month on the rad onc service and learned that this was a really cool field with great people and that radiation was a way more powerful modality than I thought. Like the impression I had going into my elective was that rads was for people who failed chemo or sx. When I did the elective, I saw patients who had incredible outcomes w/ rads as a primary modality.

But it’s really really easy to read between the lines when talking to the residents who were concerned about the market. The chiefs were all going to places in the middle of nowhere which is kinda shocking. My pulm/cc chief’s phone was going off constantly from recruiters. My ENT chiefs were constantly interviewing. Ultimately, the biggest thing is it’s not like rad onc is the only way to take care of cancer patients especially for someone who is qualified. The prospect of unemployment or severe geographic limitation after 5 years of dedicated training is really quite frightening.

 

[elementaryschooleconomics]

I wanted to add my opinion as a med student who was interested in Rad Onc but switched to ENT (and matched). If you can be successful in med school (like prev RO matriculants) you have the capacity to do some literally cursory research into the field. It’s really not that hard to verify the claims on here so not sure where this pearl clutching is coming from.

I spent a month on the rad onc service and learned that this was a really cool field with great people and that radiation was a way more powerful modality than I thought. Like the impression I had going into my elective was that rads was for people who failed chemo or sx. When I did the elective, I saw patients who had incredible outcomes w/ rads as a primary modality.

But it’s really really easy to read between the lines when talking to the residents who were concerned about the market. The chiefs were all going to places in the middle of nowhere which is kinda shocking. My pulm/cc chief’s phone was going off constantly from recruiters. My ENT chiefs were constantly interviewing. Ultimately, the biggest thing is it’s not like rad onc is the only way to take care of cancer patients especially for someone who is qualified. The prospect of unemployment or severe geographic limitation after 5 years of dedicated training is really quite frightening.

Preach.

 

[radonc17]

My explanation is ignorance and denial. Many have not considered the implications of overtraining (i.e. lower salaries). I was PD for >15 years at two programs and every year I asked the residents if they wanted more residents in the program. Every year the majority said yes. I held the complement steady but I eventually couldn't convince the faculty that growth was a bad thing and I stepped down and the complement increased. I have not worked with a resident on my service in more than 3 years. My meager contribution to trying to slow growth.

that is really illuminating and sad.

Appreciate your advocacy!

 

[radonc17]

The response to this live stream made me think of a new word, which was already defined on urban dictionary

Urban Dictionary: Twitoris

Any news item or public event, no matter how small or hard to find, that arouses a sudden and significant level of excitement from the Twitter community.

www.urbandictionary.com

In any case, wombat was right, this was the jump the shark moment. This was a last grasp at relevance for competent med students, and unless the cast gets changed, it's cancellation. It's not don't worry about what social media are saying, they're responding to what you're doing. It's, don't worry about what social media are saying because you don't have to. As Ray Zalinsky said, "Great, you've pinpointed it. Step 2 is washing it off."

I think we all have some form of radonc Stockholm syndrome

We all love the field and are trying to fix it

We cheer when we see progress, albeit minuscule

Hard to battle the machine who refuses to admit their is an issue and tries to recruit more raw numbers daily

 

[fiji128]

I wanted to add my opinion as a med student who was interested in Rad Onc but switched to ENT (and matched). If you can be successful in med school (like prev RO matriculants) you have the capacity to do some literally cursory research into the field. It’s really not that hard to verify the claims on here so not sure where this pearl clutching is coming from.

I spent a month on the rad onc service and learned that this was a really cool field with great people and that radiation was a way more powerful modality than I thought. Like the impression I had going into my elective was that rads was for people who failed chemo or sx. When I did the elective, I saw patients who had incredible outcomes w/ rads as a primary modality.

But it’s really really easy to read between the lines when talking to the residents who were concerned about the market. The chiefs were all going to places in the middle of nowhere which is kinda shocking. My pulm/cc chief’s phone was going off constantly from recruiters. My ENT chiefs were constantly interviewing. Ultimately, the biggest thing is it’s not like rad onc is the only way to take care of cancer patients especially for someone who is qualified. The prospect of unemployment or severe geographic limitation after 5 years of dedicated training is really quite frightening.

Great for you. I think ENT is an excellent choice. If I had to due it again I would give ENT hard look. Congratulations on matching.

 

[RadOncMegatron]

I wanted to add my opinion as a med student who was interested in Rad Onc but switched to ENT (and matched). If you can be successful in med school (like prev RO matriculants) you have the capacity to do some literally cursory research into the field. It’s really not that hard to verify the claims on here so not sure where this pearl clutching is coming from.

I spent a month on the rad onc service and learned that this was a really cool field with great people and that radiation was a way more powerful modality than I thought. Like the impression I had going into my elective was that rads was for people who failed chemo or sx. When I did the elective, I saw patients who had incredible outcomes w/ rads as a primary modality.

But it’s really really easy to read between the lines when talking to the residents who were concerned about the market. The chiefs were all going to places in the middle of nowhere which is kinda shocking. My pulm/cc chief’s phone was going off constantly from recruiters. My ENT chiefs were constantly interviewing. Ultimately, the biggest thing is it’s not like rad onc is the only way to take care of cancer patients especially for someone who is qualified. The prospect of unemployment or severe geographic limitation after 5 years of dedicated training is really quite frightening.

This right here is so accurate. Why would a bunch of board certified physicians come on a professional forum only to crap on their very own specialty? As @radonctoent stated these facts were not only easy to find but obvious to anybody with eyes. We all love Rad Onc and are glad a future ent colleague knows it’s power. As they wrote, elite med students have options and have enough common sense to rightly not want to be unemployed. It really is not hard.

 

[radonctoent]

This right here is so accurate. Why would a bunch of board certified physicians come on a professional forum only to crap on their very own specialty? As @radonctoent stated these facts were not only easy to find but obvious to anybody with eyes. We all love Rad Onc and are glad a future ent colleague knows it’s power. As they wrote, elite med students have options and have enough common sense to rightly not want to be unemployed. It really is not hard.

I still think about the residents who were just really cool dudes that I feel like are getting a ****ing raw deal. Tried to tell people not to SOAP on the ENT spreadsheet too. I hope things get righted in this specialty.

 

[karaokeiz4poserz]

As another medical student who pivoted in the middle of MS3 from RadOnc to another competitive surgical subspecialty (and matched very well), I want to echo that it is entirely possible to find success.

To all the med student lurkers out there: really think about what you want in your life. If you want to take care of cancer patients, you can do it through so many different specialties. Cancers can be found in virtually every organ system. If you want the tech and the gadgets, there are cool things happening in a lot of surgical/procedural specialties. If you want lifestyle and pay, once again there are other fields to pursue. Don't silo yourself into a field just because you've committed time doing research and writing RadOnc papers or that you could potentially be that "exception" to the rule. Think about how many other people with great CVs already are imagining that. And lastly, your first commitment should be to yourself and your family. If you don't advocate for yourself, do not trust that anyone else will.

It might feel terrible thinking about switching fields in the short term, but I am so incredibly grateful to have done it. It was like a weight lifted off my shoulders. If you fear disappointing your mentor(s), realize this: their short term disappointment should not compare to your lifelong regret. If they truly cared about you as a person, they would be happy for your success as you go down another path as a physician who will take great care of patients.

Thank you to the community at SDN for showing me the light early on. I've actively tried to convince other students to really think about their futures and what role RadOnc truly plays. RadOnc or not, we all have a role to play in the future of this field.

Feel free to DM me if you have questions about pivoting. It's not too late.

 

[TheWallnerus]

But it’s really really easy to read between the lines when talking to the residents who were concerned about the market. The [rad onc] chiefs were all going to places in the middle of nowhere which is kinda shocking. My pulm/cc chief’s phone was going off constantly from recruiters. My ENT chiefs were constantly interviewing.

This is why you either have to be willfully blind or just a glutton for punishment (or have no other options) to choose rad onc nowadays. You know it's hard out here for a pimp in the city. And it's even gettin hard for a MD/PhD rad onc in the boonies.

 

[Chartreuse Wombat]

​ Apr 5, 2021 10:19 PM Thomas Eichler

ASTRO appreciates the University of Colorado Department of Radiation Oncology's leadership in convening the most recent Virtual Visiting Professor Network session, and to the panelists who shared their perspectives about the 2021 Match. Insofar as many important concerns were raised, ASTRO will examine how we can work together to best address these issues. As previously outlined in a series of blog posts and the recently released workforce statement, ASTRO, as a membership organization, has no role in the selection of residents by institutions, but we also recognize that the Society has a strong influence on the culture of the specialty and certain aspects of workforce training. We aspire to be an inclusive organization, take this feedback seriously and seek to bridge divisions, working together to address the protean challenges that confront us. ------------------------------ Thomas Eichler MD, FASTRO ASTRO Chair VCU Health/Massey Cancer Center Richmond, VA 804-363-7438 ------------------------------ ugh

 

[medgator]

​ Apr 5, 2021 10:19 PM Thomas Eichler

ASTRO appreciates the University of Colorado Department of Radiation Oncology's leadership in convening the most recent Virtual Visiting Professor Network session, and to the panelists who shared their perspectives about the 2021 Match. Insofar as many important concerns were raised, ASTRO will examine how we can work together to best address these issues. As previously outlined in a series of blog posts and the recently released workforce statement, ASTRO, as a membership organization, has no role in the selection of residents by institutions, but we also recognize that the Society has a strong influence on the culture of the specialty and certain aspects of workforce training. We aspire to be an inclusive organization, take this feedback seriously and seek to bridge divisions, working together to address the protean challenges that confront us. ------------------------------ Thomas Eichler MD, FASTRO ASTRO Chair VCU Health/Massey Cancer Center Richmond, VA 804-363-7438 ------------------------------ ugh

So many words to say so little

 

[metallica81788]

So many words to say so little

Leadership politics at its finest and most predictable

 

[TheWallnerus]

​ Apr 5, 2021 10:19 PM Thomas Eichler

ASTRO appreciates the University of Colorado Department of Radiation Oncology's leadership in convening the most recent Virtual Visiting Professor Network session, and to the panelists who shared their perspectives about the 2021 Match. Insofar as many important concerns were raised, ASTRO will examine how we can work together to best address these issues. As previously outlined in a series of blog posts and the recently released workforce statement, ASTRO, as a membership organization, has no role in the selection of residents by institutions, but we also recognize that the Society has a strong influence on the culture of the specialty and certain aspects of workforce training. We aspire to be an inclusive organization, take this feedback seriously and seek to bridge divisions, working together to address the protean challenges that confront us. ------------------------------ Thomas Eichler MD, FASTRO ASTRO Chair VCU Health/Massey Cancer Center Richmond, VA 804-363-7438 ------------------------------ ugh

Where'd my man Tom T. Thespian post this putrescent, dissembling drivel. On the tweet tweet? Can't find it. Lemme know. I'll at-at him faster than an Imperial walker.

 

[w00tz]

But it’s really really easy to read between the lines when talking to the residents who were concerned about the market. The chiefs were all going to places in the middle of nowhere which is kinda shocking. My pulm/cc chief’s phone was going off constantly from recruiters. My ENT chiefs were constantly interviewing. Ultimately, the biggest thing is it’s not like rad onc is the only way to take care of cancer patients especially for someone who is qualified. The prospect of unemployment or severe geographic limitation after 5 years of dedicated training is really quite frightening.

Yes! When I rotated as a med student in 2012, the residents were signing contracts in July-Oct in their geographic preference. In residency, I watched my senior residents struggle more and more each year - interviewing in towns I had never heard of just to get close-ish to their preferred location and signing later and later. It was such a radical change in a short period of time for me. I remember in my PGY3 year I started having this really sinking feeling about the job market and where I would potentially end up. I started prepping my wife mentally about the possibility of ending up in BFE for maybe a couple years, saving aggressively, then FIRE. Fortunately, the stars aligned and I ended up in what I considered a decent job. But I also really lowered my standards of what I considered a decent job over the years (must have decent biriyani) after seeing where my senior residents were going (some had no biriyani). I'm sure it's only gotten worse since then and will continue to get worse. I see no light at the end of this tunnel right now. I feel bad for current residents. Future residents are at least aware of what they signed up for.

 

[communitydoc13]

Young guns were all good. Dr. Royce's point that perception alone is adequate to consider a reduction in residency numbers was on point. Drs. Parikh, Pinnix and Goodman all made outstanding contributions. Dr. Kavanagh confirmed what we already knew, that reducing residency numbers is not a good look for an academic chair.

Potters is as welcome to an anonymous internet account as anyone, where he can trust in the soundness of his anonymous arguments to win the day.

The antitrust issue reared its head in a couple ways.

Dr. Pinnix made a point to emphasize that the decision to reduce spots at MDACC was unilateral.

Dr. Parikh mentioned that a hypothetical plaintiff regarding an antitrust suit might in fact be a chair or department itself.

I'm not sure that these are congruent concerns regarding antitrust.

I'm guessing that Dr. Pinnix's emphasis on unilateral action was based on the concern that cooperation among programs to reduce spots could be interpreted as a means of causing antitrust injury to some downstream consumer of board certified radoncs. The only consumers I can think of are either patients or employers (hospitals or private practices). Regarding patients, we all know that there are significant regional shortages of many types of doctors, radoncs being low on the list, as is reflected in the present locums market. I don't think there is any precedent for hospitals or physician practices setting numbers of trainees at other institutions.

Now Dr. Parikh's comment was telling, because it indicated that a given program could claim antitrust injury if mandated to reduce numbers by some umbrella organization.

But isn't there a solution that is completely free of any concern of a departmental suit and will immediately improve the perceived competitiveness of the field? This would be voluntary collective action. You don't need all departments. Just get the top 30 programs to halve their residency numbers and publish the programs that have participated in the agreement. Not only would this increase the competitive value of residency at the participating programs (those 3 spots at MDACC were roughly twice as hard to come by as those 6 spots were) and the field as a whole, but it would make a major arithmetic dent in total numbers. It's easier to start at the top. The field is small and the pressure on smaller programs to follow suit will be huge. I suspect voluntary, collective action by programs was at work many years ago.