Ask a Radiation Oncology Resident Anything...

[lazers]

Hope I can answer some of your questions related to this field.

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[goofball]

Given that Rad Onc is such a competitive field, what did you do to get in besides your STEP Score/Rotation Grades? Did you take a year off for research? Did you have a Ph.D. before going to residency?

 

[Chronos]

I guess first, why rad onc? What are some of your "favorites" or "highlights" of the speciality.

Least favorite part?

 

[red7]

I've heard that the field is so competitive that MD/PhD is an unofficial requirement for the big academic programs. Is that true? Could an MD student with 1 yr off for research match at a strong academic program?

How important is it to have radonc-specific research? Will other cancer research be considered valuable?

How did you discover/develop your interest in radonc - did you know early on, and have plenty of time to get the research, etc.?


Thanks!

 

[Cinclus]

How much routine and repetition would you say this field entails? I realize that all fields have their share of routine and repetition, but in comparison to other fields, would you say it has above or below average amounts of this?

 

[SirCardiac]

Has it ever crossed your mind that a radonc is a depressing job. How do you think you will cope with treating patients with glum outlooks?

 

[patel1283]

After successfully graduating from your residency, is it difficult to find a job in a specific location? For example, you wanted to move to particular location because of family.

 

[Daodejing]

Thanks for doing this.

According to Table 84 of the following report (see pg. 3-4): http://www.ama-assn.org/resources/d...icare-physician-payment-schedule-analysis.pdf

Why do you think rad onc took such a big hit compared to other fields in medicine? Is this something important to consider? What is your opinion on the future of the field in the volatile healthcare climate?


Also, how much does the tier of the med school you are graduating from matter, in terms of rad onc (which I sense is predominantly academic)? I would presume that it would matter insofar as the top-tier schools have the most research funding and would thus help a student make connections, gain big wig LORs, and have extensive basic/clinical research opportunities. But I'd love to hear your personal thoughts.

 

[nychila]

Is research in radiation oncology almost mandatory to land a residency in that field?

 

[IslandStyle808]

How much patient interaction do you get in comparison to other fields?

 

[lazers]

Given that Rad Onc is such a competitive field, what did you do to get in besides your STEP Score/Rotation Grades? Did you take a year off for research? Did you have a Ph.D. before going to residency?

I took a year off during medical school and did dedicated research. This is by no means necessary and the majority do not spend a dedicated year in research. Though research is weighted in residency applications and completing at least a small project (such as a retrospective clinical study) will definitely increase your chances of getting accepted.

I guess first, why rad onc? What are some of your "favorites" or "highlights" of the speciality.

Least favorite part?

There's a couple of reasons for this:
1. I found the technology used in radonc quite fascinating.
2. I liked to be in a field where I could see the results of my work. For example in a Stage III head and neck cancer you can see the cancer disappearing after radiotherapy. Also patients are definitely appreciative for the work you do for them.
3. I liked the controlled setting for radiation oncology. There's a lot of quality assurance completed during a radiotherapy treatment to make sure an error in delivery doesn't happen.

My least favorite part is how you can't cure everyone and some patients will die from their disease. Another negative is that you can't have your own practice as the equipment are very expensive (a regular linear accelerator needed for your most basic treatments costs $4million!)

I've heard that the field is so competitive that MD/PhD is an unofficial requirement for the big academic programs. Is that true? Could an MD student with 1 yr off for research match at a strong academic program?

How important is it to have radonc-specific research? Will other cancer research be considered valuable?

How did you discover/develop your interest in radonc - did you know early on, and have plenty of time to get the research, etc.?


Thanks!

You do not have to be an MD/PhD to get accepted to a strong academic program. Though it would be advantageous. An MD with 1 year off can match at a strong program. The best chances for that would be if your medical school is part of that program and you take your year off completing research in that program.

You should spend your time completing radonc specific research. Other research is useful especially if it's oncology related. However I would say completing a research project completely unrelated to oncology or radonc won't benefit you as much.

I developed interest after I heard of the program from a friend of mine who was also interested in radonc. I did take a research year off for an unrelated reason however that research year definitely helped me match. The year was a very productive research year and I had several publications.

How much routine and repetition would you say this field entails? I realize that all fields have their share of routine and repetition, but in comparison to other fields, would you say it has above or below average amounts of this?

There's relatively less repetition in radonc than other fields. The main reason for this is that you treat cancers in all parts of the body with each requiring different treatments. You also treat non cancerous conditions such as AV malformations, keloids, and meningiomas.

Has it ever crossed your mind that a radonc is a depressing job. How do you think you will cope with treating patients with glum outlooks?

I don't think radonc is a depressing job. The majority of patients coming to you will likely be cured of their cancer. I do have some patients who have a poor prognosis and I do my best to help them. I do think about these patients occasionally but it doesn't cause me to become depressed. If anything they make me appreciate my life and what I have more.

After successfully graduating from your residency, is it difficult to find a job in a specific location? For example, you wanted to move to particular location because of family.

Yes, this is the biggest negative of this field. Straight out of residency it would be difficult to have a job in a highly desired location. However after a couple of years of practice you can move to that said local.

Thanks for doing this.

According to Table 84 of the following report (see pg. 3-4): http://www.ama-assn.org/resources/d...icare-physician-payment-schedule-analysis.pdf

Why do you think rad onc took such a big hit compared to other fields in medicine? Is this something important to consider? What is your opinion on the future of the field in the volatile healthcare climate?


Also, how much does the tier of the med school you are graduating from matter, in terms of rad onc (which I sense is predominantly academic)? I would presume that it would matter insofar as the top-tier schools have the most research funding and would thus help a student make connections, gain big wig LORs, and have extensive basic/clinical research opportunities. But I'd love to hear your personal thoughts.

I think radonc took a big hit because proton therapy was hit hard. They took a big hit mostly because it wasn't proven to be any ore efficacious than IMRT in several trials. Proton therapy reimbursements were reduced to be more in line with IMRT treatments. Like all other fields in medicine I don't think you should go in to for the money as you will likely make less than what the physicians are making today.

Tier of medical school does matter. That's true for any competitive field. This is due to the items mentioned above.

Is research in radiation oncology almost mandatory to land a residency in that field?

I would say so. Again it doesn't have to be a PhD but a summers worth of research completing a small retrospective clinical study would be sufficient to have shown your interest in research.

How much patient interaction do you get in comparison to other fields?

60% of your time is patient interaction and 40% is developing the treatment plans for the patient. I think this is the perfect blend

 

[Sephiroth]

To what extent is research a normal part of your job? I know you've said here, and it has been said in the radonc forums that research is critical for getting into the field. But I recall Gfunk and Neuronix tlaking about there being an issue with radonc in particular in that clinical practice is so much more lucrative than research that it really disincentivizes research careers. So I'm wondering how much or little the clinical and research aspects of the feild intertwine given how research-intensive the field seems to be.

 

[nBeeDee]

Thanks for doing this!

I know you already answered why rad onc, but how did you come to that decision during medical school? Did you develop your interest through pre-clinical coursework, a related rotation, during a rad-onc elective, or maybe always had it in mind? Do you feel that the average med student has enough exposure to the field in general to make a specialty decision, or is it something you have to pursue outside of school? What are some other specialties you considered during med school and why didn't you choose them?

 

[lazers]

To what extent is research a normal part of your job? I know you've said here, and it has been said in the radonc forums that research is critical for getting into the field. But I recall Gfunk and Neuronix tlaking about there being an issue with radonc in particular in that clinical practice is so much more lucrative than research that it really disincentivizes research careers. So I'm wondering how much or little the clinical and research aspects of the feild intertwine given how research-intensive the field seems to be.

I spend approximately 5% of my time as a resident doing research. Most programs have 6 months of dedicated research which is nice since you don't have to be worried about seeing patients and running the clinic. Of course as an attending whether you do research or not is completely up to you. There are many private practice attendings who do no research.

So the structure of payment for most hospital based radonc centers (for attendings) includes a base salary followed by a bonus if you see more patients. The bonus is usually per patient you see. Therefore it is more lucrative to see more patients. However a lot of attendings don't care about the bonus and would rather spend time completing significant research and so they forego said bonus. This isn't unique to radonc and for almost all fields you get paid less if you do academics and get involved with research as opposed to doing private practice. Private practice radonc usually involves working in a community hospital's radiation oncology department. I think there are going to be fewer and fewer independently owned centers as time goes on due to health care reform.

Thanks for doing this!

I know you already answered why rad onc, but how did you come to that decision during medical school? Did you develop your interest through pre-clinical coursework, a related rotation, during a rad-onc elective, or maybe always had it in mind? Do you feel that the average med student has enough exposure to the field in general to make a specialty decision, or is it something you have to pursue outside of school? What are some other specialties you considered during med school and why didn't you choose them?

After a friend of mine talked about the field I became intrigued and decided to do an elective in radonc. I don't feel like you get exposed to radonc sufficiently to get a good feel of the field until you've done a clinical elective in radonc. Other specialties I was considering included cardiology and surgery.

 

[nychila]

How many hours do radiation oncology attendings work in a week on average? Is there a lot of call? What does their total compensation look like after 10 years of practice?

 

[dwills]

Can you describe what you do on a typical day?

 

[lpmarcus010]

I have a question here from a medical student. I came into medical school wanting to do RadOnc because I worked for a device manufacturer in Palo alto selling linacs and planning software after college. When I finally got to school and started working with residents and attendings at our cancer center, I became very discouraged about RadOnc because it seemed like it was more "tech-y" than "medicine-y". Most of the patient management was performed by someone in medicine, clinic visits were mostly performed by nurses, treatment was delivered by therapists, and most of the technical planning was done by physicists. After spending a year and a half in front of a computer screen watching people draw contours on a CT sim, I started looking for something else to do. My question is: what in particular excites you about Radiotherapy in practice? Please do not take this a snarky or condescending question because I truly am interested in RadOnc. Before I decide that RadOnc is not for me, I would like to know if maybe my experience is specific to my institution only? Thanks in advance...

 

[lazers]

How many hours do radiation oncology attendings work in a week on average? Is there a lot of call? What does their total compensation look like after 10 years of practice?

A typical radiation oncology attending works approximately 50-55 hours per week. Like any field in medicine there is call. The nice thing about radonc is that call is home call. So when I'm on call I stay at home and answer pages from home. This is as opposed to an internal medicine or surgery resident who has to stay at work during call. Call is generally a week at a time, but you rarely have to go to the hospital on a call day after the regular work day.

Compensation varies widely and I wouldn't go into any field of medicine purely for compensation. Also you won't make as much as the attendings are making today no matter what field of medicine you go into. I know of attendings in radonc working full time 10 years out making as low as $350K/year and others making as high as $1.5million/year.

Can you describe what you do on a typical day?

Typical work day starts at 7am or 8am depending on if there is tumor board. After tumor board we meet with the dosimetrists, physicists, and nurses regarding the patients I'm going to be consulting on for that day and the patients who are going to be simulated or need their plans developed. From 9-12pm I see between 1 to 2 consults. From 12-1pm I attend another tumor board (lunch always provided). From 1pm-5pm I spend my time either contouring patients, placing fields, checking the plans of the dosimetrists and physicists, and simulating patients. One day per week you see all the patients that are currently on treatment. 5pm I go home In radonc I work 5 days per week and get Saturdays and Sundays off (unless I'm on call and there's an emergency during the weekend, which typically happens once every 2 months).

 

[yellowfish]

Compensation varies widely and I wouldn't go into any field of medicine purely for compensation. Also you won't make as much as the attendings are making today no matter what field of medicine you go into. I know of attendings in radonc working full time 10 years out making as low as $350K/year and others making as high as $1.5million/year.

What are the factors in the huge discrepancy in compensation? Hours worked? Partner in a private practice vs. academic position? Rural vs. urban? Training?

 

[lazers]

What are the factors in the huge discrepancy in compensation? Hours worked? Partner in a private practice vs. academic position? Rural vs. urban? Training?

The discrepancy is largely due to being a partner in a private practice where you can get the proceeds of the technical fees.

 

[def1]

What would you advise for someone who might be interested in this specialty but is going to an MD school without a rad-onc department?

 

[dwills]

Thanks. One more. How strong of a physics background do you think is necessary? Do you have to understand the science behind radiation therapy in depth or just the clinical applications of it. I know it's probably both, but before starting recidency what was your background knowledge/physics background in the science behind radiation treatments?

 

[ToldYouSo]

Thanks. One more. How strong of a physics background do you think is necessary? Do you have to understand the science behind radiation therapy in depth or just the clinical applications of it. I know it's probably both, but before starting recidency what was your background knowledge/physics background in the science behind radiation treatments?

Also curious as to how strong of a physics background one needs to have to be in the specialty. Thanks a lot for doing this!

 

[wholeheartedly]

Thanks. One more. How strong of a physics background do you think is necessary? Do you have to understand the science behind radiation therapy in depth or just the clinical applications of it. I know it's probably both, but before starting recidency what was your background knowledge/physics background in the science behind radiation treatments?

3rd being curious about this, is it rads or rad onc that has a whole separate physics boards?

 

[nychila]

Also you won't make as much as the attendings are making today no matter what field of medicine you go into.

Could you explain this statement please? Is it because of the expected drop in doctors' salaries with the current health care reform?

 

[45408]

I know of attendings in radonc working full time 10 years out making as low as $350K/year and others making as high as $1.5million/year.

5pm I go home In radonc I work 5 days per week and get Saturdays and Sundays off (unless I'm on call and there's an emergency during the weekend, which typically happens once every 2 months).

My God....

oh to be a rad onc resident, lol

 

[lazers]

Thanks. One more. How strong of a physics background do you think is necessary? Do you have to understand the science behind radiation therapy in depth or just the clinical applications of it. I know it's probably both, but before starting recidency what was your background knowledge/physics background in the science behind radiation treatments?

You do need to understand the science behind radiation therapy as you will be taking a physics board exam at the end of your third year. Prior to residency most applicants have only the basic physics requirements required to get in to medical school. You will have a physicist assisting you during residency and when you are an attending.

Also curious as to how strong of a physics background one needs to have to be in the specialty. Thanks a lot for doing this!

Again you don't need an understanding beyond basic undergrad physics prior to entering residency. During residency you will get training in physics (1 hour per week of lecture in physics during residency for 3 years) which should prepare you for the physics needed for the board exam and practice.

3rd being curious about this, is it rads or rad onc that has a whole separate physics boards?

Radonc has a whole separate physics board you will take at the end of your third year. You will need to know more physics than a radiologist as a radiation oncologist. You will be using radiation beams for therapy as opposed to diagnosis so you need to have a good understanding of radiation physics by the time you finish residency.

Could you explain this statement please? Is it because of the expected drop in doctors' salaries with the current health care reform?

Yes, however this isn't unique to radiation oncology and will happen with every field in medicine. That's why I highly discourage going in to any field purely for the compensation package. You should go to the field that sparks your interest. I find radonc fascinating and rewarding which is why I chose the field. The nice hours are a plus but I don't just go home and relax. I go home and study the current cancer literature, and complete clinical research projects which add to the field. These are all voluntary and not required but I do enjoy doing them and find it rewarding when I've published a paper or present at an annual conference.

 

[IniestaDeMiVida]

This may be a silly question, but what will rad oncs do if the treatment for cancer changes? With so much money filtering into research, what will happen if a better treatment method is established?

Also, when in medical school did you know you wanted to get into it? And how? Did you shadow?

 

[lazers]

This may be a silly question, but what will rad oncs do if the treatment for cancer changes? With so much money filtering into research, what will happen if a better treatment method is established?

Also, when in medical school did you know you wanted to get into it? And how? Did you shadow?

This isn't a silly question but a very good question. Over the past 20 years the applications for radiation has been increasing due to the increased complexity and modalities for radiation delivery. For example radiation oncologists are now performing Stereotactic Radiosrugery as a replacement to the tumor resections formerly completed by surgeons. So for example if a patient had a single brain metastasis 10 years ago most centers would've completed a neurosurgical intervention. However today most centers would complete stereotactic radiosurgery (which is performed by a radiation oncologist). The same applies to stage IA lung cancer were there are current randomized trials comparing resection to stereotactic radiosurgery. As chemotherapy and targeted therapy advance, localized therapy (radiation or surgery) become more important to decrease the high tumor burden in the primary, while chemotherapy and targeted agents eliminate the micrometastases. In addition today there are many studies on radiation sensitizers (chemotherapy and targeted agents) which cause a synergistic interaction to increase tumor kill.

I became interested in my third year of medical school after I did a radiation oncology elective.

 

[dwills]

Yes, however this isn't unique to radiation oncology and will happen with every field in medicine. That's why I highly discourage going in to any field purely for the compensation package. You should go to the field that sparks your interest. I find radonc fascinating and rewarding which is why I chose the field. The nice hours are a plus but I don't just go home and relax. I go home and study the current cancer literature, and complete clinical research projects which add to the field. These are all voluntary and not required but I do enjoy doing them and find it rewarding when I've published a paper or present at an annual conference.

What do you think a reasonable estimate is for the median salary of a rad onc attending in 20 years? How about those with lower salaries such as primary care or those with higher salaries such as ortho/rads?

 

[IniestaDeMiVida]

This isn't a silly question but a very good question. Over the past 20 years the applications for radiation has been increasing due to the increased complexity and modalities for radiation delivery. For example radiation oncologists are now performing Stereotactic Radiosrugery as a replacement to the tumor resections formerly completed by surgeons. So for example if a patient had a single brain metastasis 10 years ago most centers would've completed a neurosurgical intervention. However today most centers would complete stereotactic radiosurgery (which is performed by a radiation oncologist). The same applies to stage IA lung cancer were there are current randomized trials comparing resection to stereotactic radiosurgery. As chemotherapy and targeted therapy advance localized therapy (radiation or surgery) become more important to decrease the high tumor burden in the primary, while chemotherapy and targeted agents eliminate the micrometastases. In addition today there are many studies on radiation sensitizers (chemotherapy and targeted agents) which cause a synergistic interaction to increase tumor kill.

I became interested in my third year of medical school after I did a radiation oncology elective.

That does make me feel better about the future of rad onc.

So you did the year of research because you didn't get into the field before third year?

 

[FatherOfEther]

Hi, I know that you've became interested in rad. onc. in your third year and took a year off for research, but I'm wondering if you know people who took a different route. Specifically, most schools have a few months off between M1 and M2 and students decide to do research during that time. I'd think that it would be too early for me to find a specialty I like and find research in that field to land a good residency. And I hear that many people go into medicine wanting one specialty and choosing something completely different. I guess my question is how do most people pick the research project they want without knowing their step 1 scores or without having done any rotations yet to see what sparks their interest. Sorry for the rant but this has been on my mind for a while. Thank you!

 

[lazers]

What would you advise for someone who might be interested in this specialty but is going to an MD school without a rad-onc department?

I recommend doing a couple of away rotations in radiation oncology departments outside of your school. If there is a radiation oncology program near the region you are in I recommend participating in a research project in that department. If there are no opportunities to complete radiation oncology related research in your region, I recommend getting involved in medical oncology related research and completing a research project during one of your elective rotations away from your program.

 

[Daodejing]

Thanks for your response to my previous question. As a follow-up, I was wondering how one can ascertain whether a particular faculty member is a 'big wig' in the field or not? Is there any way to know other than by talking to upperclassmen and current residents?

Also (not really rad onc related), but I've noticed that many med school faculty profiles (on school webpages) have pubs every 1-2 years (or a few in a given year), which is fine. But I assume that many of these faculty work with students putting out case reports, chart reviews, etc. Are these clinical research pubs usually not included for any specific reason? I'm guessing it's because they hardly matter/add any credential to the faculty member but I wanted to know if you can confirm or have any more knowledge on this.

 

[NewYorker9]

If I'm going to enter med school in the fall and believe I have an interest in radiation oncology, what is the best thing I can do during my first year to further this interest and best prepare myself (besides pass all my classes and learn material)? Would you recommend shadowing, research, interest groups, trying to get connected with current students that had completed that elective, etc.?

Seriously, thank you for doing this

 

[An MD Hopeful]

Thanks for doing this!

I actually have a very general question about medical school, specifically about research during medical school. If I'm interested in doing clinical research during my career, would residencies prefer to see me do clinical research during medical school, or would it be okay to just do basic science research (which seems to be easier to find) during med school as long as my research is in my field of interest?

Also, which one is more likely to result in a publication during med school: basic science or clinical research?

 

[iforget2]

Very general question, but as a resident, how much time do you have to do things you want to do like hanging out with friends and basketball?

 

[Thego2guy]

As an expert, can you briefly describe the differences/overlap in the clinical work of radonc, interventional radiology, regular (diagnostic?) radiology and regular oncology. I never fully understood the differences between them, and never understood the fellowship process. For example, one becomes a neuroradiologists after completing a fellowship following their rads residency? What do neurorads do? If the pt has a cranial malignancy, who takes care of it, radonc or neurorad?

On a separate note you mentioned you work closely with physiscists. Are they PhDs? Do they do research and advise in clinic, or they can do purely clinical work? What exactly do they do? How much do they get paid? How many physicists do you guys have as consults? (1 physics consult per department? I can't imagine a hospital hiring a bunch of physiscists)

Thanks a lot!

 

[MangoPlant]

If one were to get a PhD in radiation physics from an MD/PhD program, would that person be able to perform without the physicist consultation?

 

[Eiot]

I don't think radonc is a depressing job. The majority of patients coming to you will likely be cured of their cancer. I do have some patients who have a poor prognosis and I do my best to help them. I do think about these patients occasionally but it doesn't cause me to become depressed. If anything they make me appreciate my life and what I have more.

This helped me immensely, thank you.

 

[lazers]

Thanks for your response to my previous question. As a follow-up, I was wondering how one can ascertain whether a particular faculty member is a 'big wig' in the field or not? Is there any way to know other than by talking to upperclassmen and current residents?

Also (not really rad onc related), but I've noticed that many med school faculty profiles (on school webpages) have pubs every 1-2 years (or a few in a given year), which is fine. But I assume that many of these faculty work with students putting out case reports, chart reviews, etc. Are these clinical research pubs usually not included for any specific reason? I'm guessing it's because they hardly matter/add any credential to the faculty member but I wanted to know if you can confirm or have any more knowledge on this.

The way I found out who are the "big wigs" in radonc are is through talking to the other residents and attendings. Also you can see who the editors for the major books in radonc are and who the chairmen/ directors at the major institutions are. The best way to get a good publication isn't by working with a bigwig but by working with a friendly attending who will make you first author once you write the paper.

My guess would be the same that case reports generally don't add to ones CV so they don't include it.

If I'm going to enter med school in the fall and believe I have an interest in radiation oncology, what is the best thing I can do during my first year to further this interest and best prepare myself (besides pass all my classes and learn material)? Would you recommend shadowing, research, interest groups, trying to get connected with current students that had completed that elective, etc.?

Seriously, thank you for doing this

Yes, I would recommend shadowing and letting the radonc department know early on that you're interested in radonc and would like to get involved with research.

Thanks for doing this!

I actually have a very general question about medical school, specifically about research during medical school. If I'm interested in doing clinical research during my career, would residencies prefer to see me do clinical research during medical school, or would it be okay to just do basic science research (which seems to be easier to find) during med school as long as my research is in my field of interest?

Also, which one is more likely to result in a publication during med school: basic science or clinical research?

I think either type of research is good. But just being involved in a research project isn't as impressive as publishing a manuscript or presenting at ASTRO (the annual conference for radiation oncologists). In my opinion it is more difficult to get a publishing or presentation out of basic science than clinical research.

Very general question, but as a resident, how much time do you have to do things you want to do like hanging out with friends and basketball?

I can probably play basketball or hangout with friends everyday if I wanted to.

As an expert, can you briefly describe the differences/overlap in the clinical work of radonc, interventional radiology, regular (diagnostic?) radiology and regular oncology. I never fully understood the differences between them, and never understood the fellowship process. For example, one becomes a neuroradiologists after completing a fellowship following their rads residency? What do neurorads do? If the pt has a cranial malignancy, who takes care of it, radonc or neurorad?

On a separate note you mentioned you work closely with physiscists. Are they PhDs? Do they do research and advise in clinic, or they can do purely clinical work? What exactly do they do? How much do they get paid? How many physicists do you guys have as consults? (1 physics consult per department? I can't imagine a hospital hiring a bunch of physiscists)

Thanks a lot!

This is a good question. I would say there is very little overlap between radonc and the other fields mentioned.

-Diagnostic radiologist: Generally look at diagnostic x-rays, CT-scans, MRIs and mammogram and report their findings. They do not do procedures

-Interventional radiologist: They do not administer any therapeutic radiation. What they do is to use CT scans, fluroscopy or ultrasound to complete invasive procedures. For example they use a CT scan to biopsy a patients tumor. They do not use the radiation from the CT scan to treat the tumor.

-Medical Oncology: Use chemotherapy that is usually administered intravenously or orally to treat the patients cancer.

-Neuroradiologist: These are basically diagnostic radiologist of the brain. They look at MRIs of the brain and report their findings. They do some minimal interventional radiology where they iuse imaging modalities to complete procedures. Again they do not administer therapeutic radiation.

-Radiation oncologist: Administers therapeutic radiation to treat cancers and other benign conditions. So for example if a patient has a cranial malignancy it is the radiation oncologist who completes the stereotactic radiosurgery where high dose radiation is targeted to the tumor to ablate it.

Medical Physicists are generally PhDs. Some medical physicists work purely in the clinic. We have one physicists per machine. So in a department with 6 linacs and one HDR machine we have 7 physicists. They generally do the quality assurance needed to make sure the machine is running as desired. They also check to make sure the treatment delivery is according to what's been approved by the physician. They get paid between 120k - 150k.

If one were to get a PhD in radiation physics from an MD/PhD program, would that person be able to perform without the physicist consultation?

The PhD would need to be in Medical Physics and not radiation physics. A medical physicist does much of the necessary QA. I assume you could do it once you're certified as a medical physicist. However I think its a good idea to have a secondary person check your work to assure safety. You might make the same mistake twice when running the QA!

 

[An MD Hopeful]

I think either type of research is good. But just being involved in a research project isn't as impressive as publishing a manuscript or presenting at ASTRO (the annual conference for radiation oncologists). In my opinion it is more difficult to get a publishing or presentation out of basic science than clinical research.

Makes sense. Thanks!

Also, I have a question about case reports. Is it possible for medical students to get involved in writing case reports with attendings? How would you suggest finding those types of opportunities? Is it possible for medical students to ask to get involved in writing case reports without stepping on anyone else's (e.g. residents) toes?

 

[Plane148]

Awesome thread, very helpful and informative

 

[jabronee]

I'm pretty sure I'll be doing research in my time off between M1 and M2. I don't have any specialty I'm particularly attracted to yet so what kind of project would you recommend I try to get involved in given that I haven't done any clinicals yet to get a better feel for what I might like to do.

 

[Daodejing]

The way I found out who are the "big wigs" in radonc are is through talking to the other residents and attendings. Also you can see who the editors for the major books in radonc are and who the chairmen/ directors at the major institutions are. The best way to get a good publication isn't by working with a bigwig but by working with a friendly attending who will make you first author once you write the paper.

My guess would be the same that case reports generally don't add to ones CV so they don't include it.

Thanks, lazers. This is one of the few specialties (in medicine anyway) that I'm very interested in, and your advice has been invaluable.

 

[loveoforganic2]

Could you give a brief overview of the care you provide a "standard" patient over the course of their therapy? In other words, how many separate times might you see a patient (including assessment and post-treatment, if you do that), how long do these last on average, and how long the time span is from 1st visit to final visit?

Sorry if the question is confusing, mostly interested in continuity of care and opportunity to form a relationship with the patient

 

[Hemorrage]

do you have any general advice you would have given yourself while you were a pre-med?

 

[113]

Rank Stanford, Penn, UCLA, MIR, and Chicago for program quality. Ignore location.

 

[iforget2]

Working in a field that may experience death more often than other fields, how hard is it for you to deal with a death of a patient and how do you deal with it?

 

[cnfz]

Kinda similar to a previous question.. Do you have any advice for someone who goes to an unranked MD school with no home department? Luckily, I'm near Chicago so there are several RadOnc departments in the city. Since you said that med school tier does matter, would taking a year off to strengthen your app be more advisable?