Which of these Canadian Rad Onc Training Programs are the best overall programs from the perspective of US staff? [Poll]

[AAAmeds]

Hi everyone! I'm a 4th year Canadian medical student applying to Rad Onc in Canada. I am currently making my rank order list, and one factor that I am considering is the prestige and overall reputation and quality of the program particularly with respect to the perspective of U.S. radiation oncologists as I am hoping to move to the U.S. for post-residency employment.

So please select your top 2 programs that you would rank highly if you had all these options available. Thanks

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[medgator]

PMH and McMaster... Maybe Sunnybrook too?

 

[deleted1098629]

I suppose PMH although I have to say citizenship matters more for US employment. Your training would be considered equivalent but that's part of the equation

Job market is terrible as is in the US. We've had numerous Canadians apply over the last few years in my institution and we've hired exactly zero

We do not sponsor visas. We cannot justify it because we have plenty of US citizens applying for jobs

You'd be forced into an undesired job. My advice is to do whatever you have to do to get employed in Canada. If one of those programs has a better track record of hiring their own grads then pick that one!

 

[communitydoc13]

I would recognize PMH (I'm assuming that's UT and not affiliated with other training programs?) and McMaster but it would make no difference in a community practice. If hiring, we would hire an American grad while knowing that you had received excellent training.

Regarding general regard of Canadian education/training, I have Malcolm Gladwell to blame for my general perception that all Universities (and by extension training programs) in Canada are very good, are regional and are not superlative relative to one another exempting the Waterloo Physics program.

 

[RickyScott]

Hi everyone! I'm a 4th year Canadian medical student applying to Rad Onc in Canada. I am currently making my rank order list, and one factor that I am considering is the prestige and overall reputation and quality of the program particularly with respect to the perspective of U.S. radiation oncologists as I am hoping to move to the U.S. for post-residency employment.

So please select your top 2 programs that you would rank highly if you had all these options available. Thanks

You are more likely to land a job in Saskatchewan than the us. Would rethink your choice of specialties. Canadians routinely have 1-2 worthless fellowship center years.

 

[TheWallnerus]

Hi everyone! I'm a 4th year Canadian medical student applying to Rad Onc in Canada. I am currently making my rank order list, and one factor that I am considering is the prestige and overall reputation and quality of the program particularly with respect to the perspective of U.S. radiation oncologists as I am hoping to move to the U.S. for post-residency employment.

So please select your top 2 programs that you would rank highly if you had all these options available. Thanks

Make sure you go to Toronto. If you do, make sure you say Princess Margaret in the states eh.

 

[dieABRdie]

Hi everyone! I'm a 4th year Canadian medical student applying to Rad Onc in Canada. I am currently making my rank order list, and one factor that I am considering is the prestige and overall reputation and quality of the program particularly with respect to the perspective of U.S. radiation oncologists as I am hoping to move to the U.S. for post-residency employment.

So please select your top 2 programs that you would rank highly if you had all these options available. Thanks

From your Avatar I'm going to suggest BC maybe

 

[deleted1098629]

Make sure you go to Toronto. If you do, make sure you say Princess Margaret in the states eh.

What he said, and still your odds aren't great for US employment

Looks like the Toronto program has both PMH and Sunnybrook but Sunnybrook hasn't become a household name in the US yet despite the most recent ASTRO abstract

If you really must tussle with US grads in 5 years maybe the Toronto program gives you a better shot. I don't know. I'll reiterate, makes no difference for my department.

 

[RickyScott]

I haven’t had a great experience with Canadians in us academic centers. Probably because their best and brightest were not going into radonc.

 

[Neuronix]

I suppose PMH although I have to say citizenship matters more for US employment. Your training would be considered equivalent but that's part of the equation

Job market is terrible as is in the US. We've had numerous Canadians apply over the last few years in my institution and we've hired exactly zero

We do not sponsor visas. We cannot justify it because we have plenty of US citizens applying for jobs

You'd be forced into an undesired job. My advice is to do whatever you have to do to get employed in Canada. If one of those programs has a better track record of hiring their own grads then pick that one!

I second this. After being told by one of the Canadian institutions in the poll that Americans need not apply to a job that I was very well qualified for, I have a hard time being sympathetic.

 

[deleted1098629]

I second this. After being told by one of the Canadian institutions in the poll that Americans need not apply to a job that I was very well qualified for, I have a hard time being sympathetic.

It's the same principle. Canadian citizen come first especially those that do 1-2 years of fellowship in the institution where that job was posted.

This is the future of rad Onc in the US as well

 

[speakeroftruth]

Hi everyone! I'm a 4th year Canadian medical student applying to Rad Onc in Canada. I am currently making my rank order list, and one factor that I am considering is the prestige and overall reputation and quality of the program particularly with respect to the perspective of U.S. radiation oncologists as I am hoping to move to the U.S. for post-residency employment.

So please select your top 2 programs that you would rank highly if you had all these options available. Thanks

My immediate first thought was this must be a troll account. You have got to be kidding me.

I don't want to be mean but have you not read anything else about rad onc in the U.S. here on SDN? U.S. grads are having a hard time find a job, let alone a good/decent job. And to pull an ASTRO hand-wavy legal argument, no U.S. institution is going to want the risk of a lawsuit from a U.S. grad because they hired a Canadian instead. At least at my institution, we will not seriously consider Canadian-trained rad oncs. You might be hoping for a sweet private practice gig but I can guarantee you that you won't be able to obtain a job at one of the well-regarded private practices (none of them have a single Canadian-trained partner).

Save yourself the pain now and if possible, apply into IM->med onc. You can always find an IM job anywhere in case med onc doesn't work out and if you do med onc, you still get to do onc and you'll find a well-paying job in almost any major metro area (with rural areas paying much higher).

 

[TheWallnerus]

do med onc, you still get to do onc and you'll find a well-paying job in almost any major metro area (with rural areas paying much higher).

How many med oncs do I know that own a linac and hire a rad onc to help run a freestanding? Quite a few. That’s irony for you. A med onc (uh, or dermatologist) has much greater likelihood of opening and owning a radiation center than a radiation oncologist does. Want to do rad onc? Do it vicariously and become a med onc.

 

[medgator]

How many med oncs do I know that own a linac and hire a rad onc to help run a freestanding? Quite a few. That’s irony for you. A med onc (uh, or dermatologist) has much greater likelihood of opening and owning a radiation center than a radiation oncologist does. Want to do rad onc? Do it vicariously and become a med onc.

Or a urologist

 

[Mandelin Rain]

Or a urologist

Or a dermatologist

 

[TheWallnerus]

Or a urologist

How do you make it to Broadway (rad onc)? Practice (urology), practice (urology), practice (urology). The bitterness is real this Monday.

 

[drewdog1973]

That’s stupid to say “the best and brightest aren’t going into it” so they are low quality. Give me a break. RadOnc isn’t hard. We just created these ridiculous barriers.

 

[deleted1098629]

My immediate first thought was this must be a troll account. You have got to be kidding me.

View attachment 333679

I don't want to be mean but have you not read anything else about rad onc in the U.S. here on SDN? U.S. grads are having a hard time find a job, let alone a good/decent job. And to pull an ASTRO hand-wavy legal argument, no U.S. institution is going to want the risk of a lawsuit from a U.S. grad because they hired a Canadian instead. At least at my institution, we will not seriously consider Canadian-trained rad oncs. You might be hoping for a sweet private practice gig but I can guarantee you that you won't be able to obtain a job at one of the well-regarded private practices (none of them have a single Canadian-trained partner).

Save yourself the pain now and if possible, apply into IM->med onc. You can always find an IM job anywhere in case med onc doesn't work out and if you do med onc, you still get to do onc and you'll find a well-paying job in almost any major metro area (with rural areas paying much higher).

The issue still stands, if he/she does not have US citizenship their prospects are limited. No matter which field. No one on this forum can guarantee you that you will not be used and abused as an attending IM or Med Onc. You need a visa, you have no negotiating powers and if you lose your visa you get deported. You will say yes to anything.

If the prospects for Med Onc or IM are good in Canada then do those. We do not have a single Canadian trained Med onc at my institution either for the exact same reason. If you do Rad Onc in Canada do it at a place that hires or advocates for their own graduates.

 

[deleted1098629]

That’s stupid to say “the best and brightest aren’t going into it” so they are low quality. Give me a break. RadOnc isn’t hard. We just created these ridiculous barriers.

No field in medicine is hard. Through practice, deliberation and experience you can pick up anything.

 

[dirka]

just curious, but on the topic of employment, citizenship etc, what happens to the onslaught of J1-issued IMGs that match to rad onc in USA during this "period of waning interest"? if they're not citizens and jobs must give preference to americans, will they be forced to leave the country after their residency is over? to a smaller extent, has this already been happening? canada doesn't really have that problem (as you must be citizen or PR to match to any government-funded position in the match).

 

[deleted1098629]

just curious, but on the topic of employment, citizenship etc, what happens to the onslaught of J1-issued IMGs that match to rad onc in USA during this "period of waning interest"? if they're not citizens and jobs must give preference to americans, will they be forced to leave the country after their residency is over? to a smaller extent, has this already been happening? canada doesn't really have that problem (as you must be citizen or PR to match to any government-funded position in the match).

For the longest time ever, IMGs could only secure IM or FM positions. For those jobs it's easy to get a J1 visa waiver and then H1B visa. Those are two separate processes.

The other way to fulfill J1 visa requirement is to go home for 2 years and then apply for jobs. Some of the surgeons we have had to return back to their home countries for 2 years before applying for a job and then getting an H1B visa.

TLDR;

Get J1 visa waiver+H1B visa at a very undesirable place or area of need

Go home for 2 years then apply for jobs needing H1B at a slightly less undesirable place

IMO, it's a very bad idea for an IMG to do sub-specialty training given the visa business

 

[RickyScott]

That’s stupid to say “the best and brightest aren’t going into it” so they are low quality. Give me a break. RadOnc isn’t hard. We just created these ridiculous barriers.

That’s just my anecdotal experience. When I was in academics, Canadians were routinely having to do 2 fellowships and unemployment was a real concern -I am sure that had an effect on who selected this field. Most the Canadian grads were subar and less motivated in my very limited experience. One had to be let go because she downright sucked. What kind of “—s” goes into a field as a medstudent knowing 2 fellowships and possibility of total unemployment?

 

[taserlaser]

That’s just my anecdotal experience. When I was in academics, Canadians were routinely having to do 2 fellowships and unemployment was a real concern -I am sure that had an effect on who selected this field. Most the Canadian grads were subar and less motivated in my very limited experience. One had to be let go because she downright sucked. What kind of “—s” goes into a field as a medstudent knowing 2 fellowships and possibility of total unemployment?

What I can add too, is that people up north tend to prefer practicing up north for reasons of being closer to family, etc. As *a large generalization*, the more skilled ones may have had more opportunities to stay closer to home than go down south. The ROs in my group include a few that have previously practiced in the US, and some which have completed their ABRs, and on the whole I would say we are a very competent group (maybe excluding me, I don’t know how I got in 🤣). But what I mean to say, there may be some selection bias too with that historical cohort

 

[deleted941485]

That’s just my anecdotal experience. When I was in academics, Canadians were routinely having to do 2 fellowships and unemployment was a real concern -I am sure that had an effect on who selected this field. Most the Canadian grads were subar and less motivated in my very limited experience. One had to be let go because she downright sucked. What kind of “—s” goes into a field as a medstudent knowing 2 fellowships and possibility of total unemployment?

Field is coming full circle it seems

 

[elementaryschooleconomics]

That’s stupid to say “the best and brightest aren’t going into it” so they are low quality. Give me a break. RadOnc isn’t hard. We just created these ridiculous barriers.

I dunno, talking to some of these CNS faculty, it sure seems like you need a 260+ Step 1 score to understand and debate the existential truth of the margins used in RTOG 0539

 

[RickyScott]

I dunno, talking to some of these CNS faculty, it sure seems like you need a 260+ Step 1 score to understand and debate the existential truth of the margins used in RTOG 0539

Intellectually, Radiation oncology doesn’t require a high IQ, but when it became so unpalatable in Canada- multiple fellowships , unemployment, high likelihood of employment in Saskatchewan (if lucky), it is more likely to pull in medstudents with all sorts of issues...

 

[tawa01]

U of Toronto has both PMH and Sunnybrook. UBC/BC Cancer is one program. McMaster has one of the weaker rad onc programs. I personally don't know any who had to do two fellowships and trust me I know a lot of Canadian rad oncs. The Canadian job market has gotten much better in the recent years.

 

[drewdog1973]

U of Toronto has both PMH and Sunnybrook. UBC/BC Cancer is one program. McMaster has one of the weaker rad onc programs. I personally don't know any who had to do two fellowships and trust me I know a lot of Canadian rad oncs. The Canadian job market has gotten much better in the recent years.

Like usual, a lot of people talking out of their asses. The Canadian training programs are top notch and individual ones are of much higher quality than the trash we’ve allowed to proliferate. The residents come out very well trained. And, yeah, they have to do a fellowship; not two. Market’s better, not great.