ARRO now has Fellowship panel

[Gfunk6]

ARRO has had a Saturday seminar prior to the ASTRO annual meeting for years. One of the nice things they run is a "jobs panel" where recent grads convey their collected wisdom on the job market.

I just learned that they are including a "fellowship panel" this year.

Welcome to your future . . .

---

Members don't see this ad.

 

[Mandelin Rain]

Uff.

That sucks.

 

[seper]

that's good


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[DukeNukem]

They've had these in the past too. I remember one that happened two years ago. It involved fellowship directors trying to sell the room on why they should do fellowships.

What has been more interesting for me personally is that for years the ARRO MD/PhD subcommittee "CROPS" would have a section to discuss physician-scientist areas of interest. This was relatively well attended. ASTRO got rid of it last year.

 

[thaddeus]

this is sadly appropriate, as there seem to be more posted fellowship positions than actual jobs this year. anyone else feel like the flow of pre-ASTRO jobs postings is particularly meager this year compared to years past?

 

[medgator]

I'm a senior resident applying for jobs now and I have had good success emailing places directly. This has translated into some onsite interviews even pre-ASTRO. I won't be attending the fellowship session nor doing a fellowship next year.

Some of the current posted fellowships are truly scandalous in their lack of added value over residency training. The programs promoting them should truly be ashamed.

I'm happy that the chairman where I'm training has taken the position that we will not create a fellowship under any circumstances. Instead we hire people for real jobs only.

Yup. Don't depend on the ASTRO website if you want a half-way decent job IMO. Being a self-starter/go getter is very important.

Even some of the employed gigs I know of have NOT been posted there lately. Seems like it's becoming the place to post a job/fellowship when no one else wants it (or should want it).

 

[domestique]

Another one and they didn't even have the courtesy to proof read it.

http://careers.astro.org/jobs/8462062/fellowship

 

[mcrue]

This fellowship desires that you bring your own funding. Is this a new concept?

 

[OTN]

A fellowship that you have to pay them for? HA! Now that's rich. Just when you've thought these programs had scraped the bottom of the barrel in terms of respectability...

 

[Gfunk6]

Holy crap, the bar keeps going lower. Not only does this "fellowship" sound like a PGY-6/PGY-7 position but you *ALSO* have to attend Radiobiology (probably already having passed those boards) *AND* you have to pay for the privilege.

 

[medicinewoman101]

Holy crap, the bar keeps going lower. Not only does this "fellowship" sound like a PGY-6/PGY-7 position but you *ALSO* have to attend Radiobiology (probably already having passed those boards) *AND* you have to pay for the privilege.

haha just saw this one from Umich too. So it says "The Fellowship program is structured to be a two-year joint clinical and research position, although we may be able to tailor this to be a one-year opportunity if so desired."

Wait, what the what? you can tailor this amazing experience to be 1 year opportunity? So really you don't know what the f*ck you want, but youre hoping that you can convince someone to do this for 2 years. Who is deciding to put these opportunities into play? Incredibly shameful. If youre at Umich please deride your 'leaders' for this

 

[Krukenberg]

Holy crap, the bar keeps going lower. Not only does this "fellowship" sound like a PGY-6/PGY-7 position but you *ALSO* have to attend Radiobiology (probably already having passed those boards) *AND* you have to pay for the privilege.

This sounds like something more than a Sub-I but less than residency. Responsibility but you have to pay to be there!


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[evilbooyaa]

Not to be an apologist, but I have to imagine that the UMich fellowship is geared towards radiation oncologists trained outside the US or something, looking for experience in the US.

Otherwise it makes absolutely no sense to do a fellowship that you won't be even getting paid to do.

 

[Mandelin Rain]

The Michigan fellowship may be the worst training position in all of medicine. Kudos.

 

[medgator]

Not to be an apologist, but I have to imagine that the UMich fellowship is geared towards radiation oncologists trained outside the US or something, looking for experience in the US.

Otherwise it makes absolutely no sense to do a fellowship that you won't be even getting paid to do.

Nope. UMich has no shame apparently:

"Successful completion of an accredited residency in Radiation Oncology is mandatory. Foreigners who have trained in a equivalent program are also eligible."

 

[Mandelin Rain]

In 7 short years, you too can learn to draw a circle around a prostate or bracket a femur within a rectangular box.

Man, I've lost the faith. This is quite the tail spine.

 

[DebtRising]

The only way to turn the tide in over supply of rad oncs is to continue to point to the objective barometers that ASTRO, SCAROP, individual chairs, and most PDs could either careless about the job market, are ignorant of it, or are rampantly taking advantage of it.

This is a very respectable institution offering a fellowship that is at best a way to re-train people from the very low institutions (and a tactic acknowledgement that we are tolerating programs that do not train well), lure foreign grads to a labor market already saturated (see 2014 employment info published in red journal if you think this claim is my opinion or documented employment data) or a blatant exploitative position to trap someone who can't find a job and wants to attach a better name to their resume. The merits of that strategy are questionable at best. The knowledge that is advertised as part of the fellowship should be / seems self evidence to be foundational of any program designed to train an independently able radiation oncologists.... which is what the 5 year residency is licensed as.

Quite frankly - all you medical school applicants out there waiting to hear and line things up after ASTRO, please take stock of what you are getting into. Don't believe 'DebtRising', an otherwise angry person typing on the internet, look at all the data points posted on here about the job market. No one knows the future, but ignoring what is happening now won't make it easier no matter which path you choose.

 

[evilbooyaa]

Nope. UMich has no shame apparently:

"Successful completion of an accredited residency in Radiation Oncology is mandatory. Foreigners who have trained in a equivalent program are also eligible."

I'm guessing they're truly looking for the bolded. Otherwise they wouldn't post the following (bolded emphasis mine below)

At this time, we are only accepting applications from individuals who have a source of funding identified (for example, from a philanthropic foundation, home institution, or government)

I say this not as somebody who is at all a fan of whatever shenanigans UMich is trying to pull, but truly believing that the leaders of Michigan cannot be so incredibly out of touch to think that offering a fellowship WITHOUT a salary is going to attract literally anybody who graduated from a Radiation Oncology residency in the US.

On the other side - could you imagine going to a philanthropic foundation and trying to get money to support a fellowship appointment like this?

 

[radiaterMike]

I know nothing about this "fellowship" but it may be that they already have someone and being a state institution need to advertise the position to anyone who could be eligible.


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[DebtRising]

I know nothing about this "fellowship" but it may be that they already have someone and being a state institution need to advertise the position to anyone who could be eligible.

Certainly I don't know the rules of hiring positions at State institutions, but it is hard to imagine that they have a duty to post this position when fellowships aren't accredited (so there is no governing body and formal structure to maintain) and when they are requiring outside funding (ie - its not financial employment by the state and cannot be construed as using state funds to support an employee/employment position....since the 'applicant' must be self funded)

I could be wrong.

 

[thecarbonionangle]

I have said this before and I will say it again. If you are waiting for these "leaders" to step up and actually do something about the problem you are PTFO asleep! this is the fox guarding the hen house. These "leaders" will benefit from oversupply and the desperation of residents. Boomer chairs will offer you unfair salaries and hire based on who bids the lowest. How low are you willing to go to work here and be an "academic"? This same thing will happen in PP. You get hired for a few years on a non-partner track and after those few years are up, they hire another person who is even more desperate than you! If you aren't willing to work for that low pay, they will find a foreigner who did a "fellowship" and passed his boards and is just glad not to be deported by Trump.

 

[Doghard]

Looks like some people are trying to put some people on the spot.

https://www.themednet.org/index.php/question/1303

 

[redoitall]

I must say all of this scared me quite a bit. I rotated in a program with 3 PGY5. Two of them didn't find a job where they wanted and they plan on doing a fellowship. As for the third, I didn't have a chance to ask him.
After a lot of sleepless nights during my rotation, I have ultimately decided not to apply to RadOnc and I am doing Radiology instead. Of course the job market now for Rads is worse and a fellowship is not optional but mandatory now. I feel all the unknowns and the changing environment is for whatever reason scarier in Radonc than in Rads. I also happen to love Rads more but the extra fellowship year was a bit of a struggle to accept. Until I saw all the fellowships popping out in Radonc and seeing how current soon to be graduate had to think about fellowships as well.
Anyway, I bid you farewell my friends and wish you all the best.

 

[OTN]

I must say all of this scared me quite a bit. I rotated in a program with 3 PGY5. Two of them didn't find a job where they wanted and they plan on doing a fellowship. As for the third, I didn't have a chance to ask him.
After a lot of sleepless nights during my rotation, I have ultimately decided not to apply to RadOnc and I am doing Radiology instead. Of course the job market now for Rads is worse and a fellowship is not optional but mandatory now. I feel all the unknowns and the changing environment is for whatever reason scarier in Radonc than in Rads. I also happen to love Rads more but the extra fellowship year was a bit of a struggle to accept. Until I saw all the fellowships popping out in Radonc and seeing how current soon to be graduate had to think about fellowships as well.
Anyway, I bid you farewell my friends and wish you all the best.

Sorry to hear about your tough decisions, but that's the nature of things these days, unfortunately.

It is important to remember that radonc is NOT a large field. Even in relatively "good" times- like when I graduated from residency 7 years ago- there wasn't a single job available in the state of Colorado, for example. If geography is even remotely important, this isn't the field for you. Never has been, never will be.

 

[medicinewoman101]

I must say all of this scared me quite a bit. I rotated in a program with 3 PGY5. Two of them didn't find a job where they wanted and they plan on doing a fellowship. As for the third, I didn't have a chance to ask him.
After a lot of sleepless nights during my rotation, I have ultimately decided not to apply to RadOnc and I am doing Radiology instead. Of course the job market now for Rads is worse and a fellowship is not optional but mandatory now. I feel all the unknowns and the changing environment is for whatever reason scarier in Radonc than in Rads. I also happen to love Rads more but the extra fellowship year was a bit of a struggle to accept. Until I saw all the fellowships popping out in Radonc and seeing how current soon to be graduate had to think about fellowships as well.
Anyway, I bid you farewell my friends and wish you all the best.

You're making the right decision. Spoke with someone else last week that was in a similar boat and chose against rad onc after objectively considering what is happening and what our chairs and academic leaders have done to this field. Wish you the best

 

[Gfunk6]

You're making the right decision. Spoke with someone else last week that was in a similar boat and chose against rad onc after objectively considering what is happening and what our chairs and academic leaders have done to this field. Wish you the best

In the end, this was the result that RO leadership and chairs stipulated - "the market will correct itself."

 

[Burt Radnolds]

In the end, this was the result that RO leadership and chairs stipulated - "the market will correct itself."

Yep, and its a sad sad solution to the problem.

 

[OTN]

Yep, and its a sad sad solution to the problem.

I'm not sure "do precisely nothing" even qualifies as a solution.

 

[zhopv10]

I must say all of this scared me quite a bit. I rotated in a program with 3 PGY5. Two of them didn't find a job where they wanted and they plan on doing a fellowship. As for the third, I didn't have a chance to ask him.
After a lot of sleepless nights during my rotation, I have ultimately decided not to apply to RadOnc and I am doing Radiology instead. Of course the job market now for Rads is worse and a fellowship is not optional but mandatory now. I feel all the unknowns and the changing environment is for whatever reason scarier in Radonc than in Rads. I also happen to love Rads more but the extra fellowship year was a bit of a struggle to accept. Until I saw all the fellowships popping out in Radonc and seeing how current soon to be graduate had to think about fellowships as well.
Anyway, I bid you farewell my friends and wish you all the best.

In a similar boat myself. It's a fascinating field and I've loved my time in rotations and doing research but in the end I (and my family) are not willing to train for that long and in the end not have at least a decent market to go into (we also have geographical restrictions, that as we get older and our kid gets older and more enter the scene tends to get even more restrictive we are finding). It's a shame and it has taken us many discussions and much angst but in the end what can you do? Third year has thankfully helped me discover some other interests so I think I have some great directions to head to from here but it definitely hurts leaving RadOnc. Good luck to everyone applying and thanks to all on this forum and the info they have been willing to share!


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[medgator]

In the end, this was the result that RO leadership and chairs stipulated - "the market will correct itself."

Well if sdn forums are reliable, there is a thread in the radiology forum that suggests that the job market there is picking up.

Unfortunately, with the growth in spots coupled with the shameless proliferation of faux fellowships in RO, I don't see any move towards a solution like circa the 1990s when RO programs were actually shut down and the training was lengthened to 4 years which eventually sowed the seeds of the decent job market we saw even a few years ago.

The market-based correction will be slow and painful for those who train going forward

 

[thecarbonionangle]

The issues of jobs being tight is not unique to radiation oncology. Take a look at the top 5-10 cities in the country by size and you will find much lower salaries compared to the "non-desireable" areas. The issue of not being able to find jobs is also not unique. I know multiple people who were trying to find jobs in desirable areas in general medicine and had significant trouble finding something or had to take something that did not have a favorable contract because they were in a highly desirable region and did not have much bargaining power. Talk to GI and cardiology fellows and you will hear of the same problems of oversaturation. Anesthesia groups are also incredibly saturated and difficult to find jobs in the big cities.

The "market-correction" theory really is one easy to say coming from people in programs who have 3+ residents per year and have no plans to reduce their residency numbers (in fact are usually expanding) and where graduates have no problem finding jobs. Some don't even believe the majority of programs are even worthy of existing, or being in the shadows of their "world renowned" faculty. These "leaders" sure have our best interests.

 

[canadianoutlaw]

more

http://careers.astro.org/jobs/8474046

 

[evilbooyaa]

more

http://careers.astro.org/jobs/8474046

I feel like I've read this before from Columbia. 6 months for "advanced" whole brains and palliation for bone mets! Sounds like a great options for attendings who don't want to deal with the inpatient "emergency" consults for half a year.

 

[medgator]

I feel like I've read this before from Columbia. 6 months for "advanced" whole brains and palliation for bone mets! Sounds like a great options for attendings who don't want to deal with the inpatient "emergency" consults for half a year.

The description is a real piece of work... The service is "urgent" meaning that "fellows" are probably taking tons of call, more than the chiefs!

The urgent inpatient CNS service allows the Fellow to manage medically complex and highly symptomatic patients with pain and non-pain syndromes from mainly brain and spine metastases

Honestly if someone is "symptomatic" from mets, more often than not, 30/10 is probably going to be what happens.

 

[ramsesthenice]

I must say all of this scared me quite a bit. I rotated in a program with 3 PGY5. Two of them didn't find a job where they wanted and they plan on doing a fellowship. As for the third, I didn't have a chance to ask him.
After a lot of sleepless nights during my rotation, I have ultimately decided not to apply to RadOnc and I am doing Radiology instead. Of course the job market now for Rads is worse and a fellowship is not optional but mandatory now. I feel all the unknowns and the changing environment is for whatever reason scarier in Radonc than in Rads. I also happen to love Rads more but the extra fellowship year was a bit of a struggle to accept. Until I saw all the fellowships popping out in Radonc and seeing how current soon to be graduate had to think about fellowships as well.
Anyway, I bid you farewell my friends and wish you all the best.

It's all about flexibility. I just went through the job search. If you are flexible it's not all doom and gloom if you network well and have a plan. There are not many jobs advertised this year but by cold calling I managed to get interviews in some good places. Even on the west coast (I'm am from the east). Now, i had to work for it. When chairs answered my unsolicited emails they grilled me about my specific plan and wanted to know why I was interested in their institution. In the end, I landed a really good academic job in the Midwest near my family.

All that being said, there were some issues. My wife's current job is in philly. I got interviews for exactly zero good opportunities in or around philly. Fortunately, she is in quality and compliance and her skills are in great desire to academic centers and she was able to land a good job at my new institution. But I care about her career too and if she were tied to her current job I would have had to take a job at a place that is struggling to fill the position (not a good sign) or take a post doc to make things work for both of us.

Bottom line, I don't know anyone who has had to do a fellowship that wasn't tied to a specific place. There are good opportunities out there, but dont expect to find them on the ASTRO website. I hope we don't end up in a situation where all grads have to do a fellowship and I really don't think we will.

My other observation for current residents: get involved in quality improvement projects. It's the rage right now. Both academic and private people were eating that stuff. It's not even my focus but everyone is looking for people with quality improvement experience. It can set you apart and make your CV stand out. My former chief resident noticed the same thing last year.

 

[deleted18755]

I haven't been to an ARRO/ASTRO meeting in many years. Can somebody please provide a brief summary of the ARRO presentations and more specifically how everybody is doing with the job search (I understand it's early in the process)?

Part of me wonders whether it's not as bad as it seems on SDN but there is objective data out there now and just in the past few weeks I was informed about some alarming news even in my neck of the (back)woods (so maybe even "undeseriable locations" are starting to fall).

 

[medgator]

$140-150K proton "fellowship" at Beaumont

Proton Therapy Fellowship

Sounds like a really nicely paid fellowship or a really poorly paid junior faculty position....

 

[evilbooyaa]

$140-150K proton "fellowship" at Beaumont

Proton Therapy Fellowship

Sounds like a really nicely paid fellowship or a really poorly paid junior faculty position....

Fellowship director is a guy like 2-3 years removed from fellowship himself. What does this even mean?

 

[nkmiami]

How long has Beaumont had protons - 6 months? WTF. Just found this thread for the first time- my opinion of astro grows worse by the day after seeing bring- your- own funding- fellowship at umich. Would be interested to find out if someone went for that.

 

[kristofer]

Don't know what else to say other than LOL. Residents, we need to be less afraid of speaking up. If you don't think your program should be expanding residency positions to cover satellite locations or offering "fellowships," say so. You are entitled to your opinion and we should not feel bullied for publically disagreeing with policies that hurt us and the field as a whole.

 

[OTN]

If the program directors and academicians don't care enough to curtail this B.S. with all the uproar in the field, I can't imagine they'll be receptive to resident complaints. Did anyone read the new workforce issue ASTRO put out? They basically said "we're going to continue to make the field undesirable, but medical students know that, so they'll self-select out of it." I was incredulous and will NEVER, EVER support ASTRO in any way moving forward. Why these people feel no shame for what they've done/are doing is beyond me.

 

[domestique]

my opinion of astro grows worse by the day after seeing bring- your- own funding- fellowship at umich. Would be interested to find out if someone went for that.

To cite a person, dear leader Trump, whose eloquence knows no bounds, I would venture to guess that someone from a "s***hole" country took that unpaid fellowship.

Seriously though, other specialties have successfully in recent history closed programs to restrict supply. I'm thinking of ENT. There are also others. This has translated into wide availability of positions in various practice and geographic settings for that specialty.

Are we assuming the intense trend of consolidation/of buying up and staffing satellites by academic departments in our field (and, as a consequence, the increased demand on their part for the cheapest form of MD labor) is the root of this fundamental philosophical difference between our specialty and these others? if so, it's remarkable how little it takes to put a field on a path to self-destruction. There must be more to it than that.

 

[evilbooyaa]

Don't know what else to say other than LOL. Residents, we need to be less afraid of speaking up. If you don't think your program should be expanding residency positions to cover satellite locations or offering "fellowships," say so. You are entitled to your opinion and we should not feel bullied for publically disagreeing with policies that hurt us and the field as a whole.

It's a tricky balance. Seems like quite a few residents are looking for a satellite position from their residency institution for their attending job, so hard to speak up too loudly without burning that bridge.

Don't forget, they can always hurt you more.

 

[nkmiami]

To cite a person, dear leader Trump, whose eloquence knows no bounds, I would venture to guess that someone from a "s***hole" country took that unpaid fellowship. - sounds like they actually require us grad, not one from the ISIS caliphate.


Are we assuming the intense trend of consolidation/of buying up and staffing satellites by academic departments in our field (and, as a consequence, the increased demand on their part for the cheapest form of MD labor) is the root of this fundamental philosophical difference "- no hypofractionation is; consolidation is just the icing on the cake.

---The problem with residency slots is that they will always fill, just possibly not with us grads. There are always excess applicants---

 

[medgator]

---The problem with residency slots is that they will always fill, just possibly not with us grads. There are always excess applicants---

Correct. Even psych and family fills every year now. There has been an explosion in domestic/US MD and DO schools without a corresponding increase in aggregate US residency slots overall. A lot of stuff that used to go to FMGs is now being filled by AMGs. FL had 3-4 MD schools when I graduated.... I think there are like 8-9 now, and plenty of new DO schools as well, just as one state's example

 

[Dare2Dream]

They basically said "we're going to continue to make the field undesirable, but medical students know that, so they'll self-select out of it."

Not sure what that even means. There will always be plenty of qualified medical students willing to fill residency slots. Perhaps the STEP 1 average may go down from around 250 to 230 and the fraction of med students with PhDs may fall from the current ~25% but I doubt there will ever be a shortage of medical students willing to fill radonc residency slots, especially when pulling from a larger pool of adequately qualified students with average STEP scores.

 

[nkmiami]

Not sure what that even means. There will always be plenty of qualified medical students willing to fill residency slots. Perhaps the STEP 1 average may go down from around 250 to 230 and the fraction of med students with PhDs may fall from the current ~25% but I doubt there will ever be a shortage of medical students willing to fill radonc residency slots, especially when pulling from a larger pool of adequately qualified students with average STEP scores.

Me neither- they are just spewing meaningless lies and non-sequitirs.
Meanwhile they go on their merrily corrupt way of funneling patients into expanding networks of accelerating absurd prices/rates. Hypocrits to boot-I doubt they are really all that cool with free market principles as they strongly believe they deserve preferential government and monopolistic rates and reimbursements. Perchance do yo think they favor site neutral payments?

 

[medgator]

Me neither- they are just spewing meaningless lies and non-sequitirs.
Meanwhile they go on their merrily corrupt way of funneling patients into expanding networks of accelerating absurd prices/rates. Hypocrits to boot-I doubt they are really all that cool with free market principles as they strongly believe they deserve preferential government and monopolistic rates and reimbursements. Perchance do yo think they favor site neutral payments?

Astro has opposed site neutral and bundled payments in the past

 

[kristofer]

If the program directors and academicians don't care enough to curtail this B.S. with all the uproar in the field, I can't imagine they'll be receptive to resident complaints. Did anyone read the new workforce issue ASTRO put out? They basically said "we're going to continue to make the field undesirable, but medical students know that, so they'll self-select out of it." I was incredulous and will NEVER, EVER support ASTRO in any way moving forward. Why these people feel no shame for what they've done/are doing is beyond me.

I was not suggesting that the goal of speaking up should be to make them receptive. It's unrealistic to think they will be.
I am personally more than a little frustrated by the contrived academics vs. private practice battle that is rammed down the throats of residents. There seems to be a vendetta perpetuated by some (although certainly not all) against the practice of radiation oncology outside of academic centers and radiation oncologists who "only treat patients." Newsflash: the purpose of radiation oncology residencies is to train competent clinicians. Not everyone is destined to be an academician and not every patient can be treated in a major academic center in a large coastal city. One is not better than the other. They are simply different and fulfill different needs in the community.

Regarding your latter point, applicants seem to remain as competitive as they have in years past. I think there would have to be an actually significant unemployment rate after graduation to impact that, not just geographic restrictions.

 

[OTN]

Drives me crazy how the academic radoncs make it sound like those of us in private practice are nothing but money-grubbing idiots, but what’s the point of being an academic radonc if you don’t get to be an arrogant prick? Used to be because one liked to do research and move the field forward, but I can’t say that’s happened at all in our field over the last decade. Certainly isn’t money, as many of them are essentially working as they would in private practice but just making money for their academic hospital overlords. Might as well be a jerk I guess.