avg day in a rad onc residency

[modemduck]

Could someone give me an idea of what the avg day in a rad onc residency is like?
ie: wake up 6:30
get to work by 7:15
round on pts 45 minutes
etc etc etc.
signout 7:00
leave at 8

just trying to get an idea of what its like... thanks!

- RA

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[Therese737]

bump bump

 

[Thaiger75]

Could someone give me an idea of what the avg day in a rad onc residency is like?
ie: wake up 6:30
get to work by 7:15
round on pts 45 minutes
etc etc etc.
signout 7:00
leave at 8

just trying to get an idea of what its like... thanks!

- RA

There's no rounding in rad onc.

Here's an example of a typical day at some places:

8:00am New Patient Conference (some places as early as 7:30, others as late as 8:30)
8-12pm New patient consults, simulations, followups, on-treatment followups, brachy procedures (different days, different deeds)
12pm-1pm: Noon conference
1pm-5pm New patient consults, simulations, followups, on-treatment followups, brachy procedures (different days, different deeds)

 

[stephew]

the hopkins experience:
8-9 resident conference/journal club/weekly chart rounds/grand rounds/case presentation
9-5: consults/followups/on treatments/sometimes lunch
5 on:finish work/radiobio class/physics class

 

[GoodmanBrown]

Feel kinda silly bumping a 5 year old thread, but how long do each of these things take? It's still surprising to me the differences between specialties for "similar" tasks. So,

New patient consult: ?? minutes
On-treatment follow-up: ?? minutes
After treatment follow-up: ?? minutes
Simulation: ?? minutes
Brachy procedure: ?? minutes

Also, what's your ratio of each of these in terms of hours/wk. spent on a given task? Finally, in the "Ultimate Guide..." essay and in another post, it talked about the patient being "re-simmed" mid-treatment to check that the treatment is on target, etc. How much effort is required for this by the radonc? Is it just a 5 minute scan of the films, or does the doc spend considerable time on that?

Thanks!

 

[GoodmanBrown]

Wow. So you are around for ~5 minutes during sims and treatment? I figured you'd be there the entire 30 minute time slot.

So, is the majority of your day in office-based consults and treatment planning? Also, Rad Onc is always described as an outpatient specialty. Are the brachy procedures always outpatient surgery? Otherwise, I don't see how you would avoid some hospital rounding.

 

[Palex80]

8:00-8:30: Morning conference (problems, questions, announcements, etc...)
8:30-9:30: Reviewing, editing and (dis)approving treatment plans for patients, who are about to begin treatment.
9:30-10:15: E-Mailing, Facebook or in some cases seeing patients with acute problems under treatment.
10:15-10:30: Coffee break!
10:30-12:00: New patients consult
12:00-13:00: Lunch
13:00-14:00: Presentind new patients, discussing treatment schemes
14:00-17:00: Contouring, brachytherapy, science, follow ups (according to weekday)
17:00-18:30: Tumor boards and preparing new patients' files for next day
18:30: HOME!

 

[FreakFlag]

6:00 wake up, wash up, eat a big breakfast, get dressed
7:15 - arrive at work. check for changes to sched, quick emails
7:30-8:30 - some kind of educational conference
8:30-6:00 - see and staff 7 consults, contour volumes in between consults, put isocenters on sims, eat a sandwich in 5 minutes
6:00-6:15 - run the list with attending and nurse
6:15-6:30 - chat with fellow residents, check emails, update to-do, put in sim orders, preview tomorrow and day after tomorrow's schedule
6:30 - go home, eat a delicious dinner, check facebook/voice mail
7:00 - 8:45 dictate the 7 consults over the phone, lose my voice
8:45 - 9:20 listen to npr, read nytimes, get on studentdoctor.net instead of going to the gym
9:20 go to gym to run and lift weights while trying to listen to some oncology mp3
10:40 shower, eat some protein to prevent wasting
11:00 look up tomorrow's consults and/or follow-ups (or if I was good, done on Sunday for the whole coming week)
anytime from 11:00 to 1AM : go to bed and ask myself why i'm living like this

 

[medgator]

6:00 wake up, wash up, eat a big breakfast, get dressed
7:15 - arrive at work. check for changes to sched, quick emails
7:30-8:30 - some kind of educational conference
8:30-6:00 - see and staff 7 consults, contour volumes in between consults, put isocenters on sims, eat a sandwich in 5 minutes
6:00-6:15 - run the list with attending and nurse
6:15-6:30 - chat with fellow residents, check emails, update to-do, put in sim orders, preview tomorrow and day after tomorrow's schedule
6:30 - go home, eat a delicious dinner, check facebook/voice mail
7:00 - 8:45 dictate the 7 consults over the phone, lose my voice
8:45 - 9:20 listen to npr, read nytimes, get on studentdoctor.net instead of going to the gym
9:20 go to gym to run and lift weights while trying to listen to some oncology mp3
10:40 shower, eat some protein to prevent wasting
11:00 look up tomorrow's consults and/or follow-ups (or if I was good, done on Sunday for the whole coming week)
anytime from 11:00 to 1AM : go to bed and ask myself why i'm living like this

ouch

 

[asmallchild]

6:00 wake up, wash up, eat a big breakfast, get dressed
7:15 - arrive at work. check for changes to sched, quick emails
7:30-8:30 - some kind of educational conference
8:30-6:00 - see and staff 7 consults, contour volumes in between consults, put isocenters on sims, eat a sandwich in 5 minutes
6:00-6:15 - run the list with attending and nurse
6:15-6:30 - chat with fellow residents, check emails, update to-do, put in sim orders, preview tomorrow and day after tomorrow's schedule
6:30 - go home, eat a delicious dinner, check facebook/voice mail
7:00 - 8:45 dictate the 7 consults over the phone, lose my voice
8:45 - 9:20 listen to npr, read nytimes, get on studentdoctor.net instead of going to the gym
9:20 go to gym to run and lift weights while trying to listen to some oncology mp3
10:40 shower, eat some protein to prevent wasting
11:00 look up tomorrow's consults and/or follow-ups (or if I was good, done on Sunday for the whole coming week)
anytime from 11:00 to 1AM : go to bed and ask myself why i'm living like this

wow, I thought radonc was considered a lifestyle-friendly field?

perhaps this is after residency?

 

[G'ville Nole]

wow, I thought radonc was considered a lifestyle-friendly field?

perhaps this is after residency?

Definitely not after residency. Even during residency, I can count on one hand (okay, maybe two) the number of days that FreakFlag describes. I suppose it all depends on your program. I know that places like MSKCC and UMich are traditionally high volume, but to consistently expect work hours like that are the exception rather than the norm.

My resident work day was:
7:30- arrive, check on consults for the day
8-9- didactics/chart rounds, depending on day of the week
9-12- consults/follow-ups/on-treats/treatment planning
12-1- lunch/tumor boards
1-4:30- more consults/follow-up/on-treats/treatment planning

Add in the fact that whenever your attending had an academic day, so did you unless you were covering for someone. Pretty benign.

Life as an attending:
7:30- arrive, check on consults for the day
8-12- consults/follow-ups/on-treats/treatment planning/approve OBI
12-1- lunch (sometimes at home!)
1-4:30 more consults/follow-ups/on-treats/treatment planning/approve OBI except Tuesday, which is my half-day.

lather, rinse, repeat. I love my job.

 

[GoodmanBrown]

So to both wagy27 and g-ville nole, how many patients do you see on average during a day? Looks like wagy has about 6 hours of seeing patients per day, and nole has about 7 1/2 hours.

 

[GoodmanBrown]

Thanks. I really appreciate the extra info. I'm in a glide year right now, so shadowing isn't extremely feasible since I'm not in school and working full time. But, I'll probably shadow a radonc doc in the first couple of months of med school (hopefully starting in fall 2010).

 

[G'ville Nole]

My mix of consults and follow-ups during residency was about as Wagy described above.

So far, my days in private practice are busy, but in a different way. As a new doc, I obviously haven't built enough of a patient load to have a busy follow-up schedule, so most of my schedule is taken up with consults (2-4 per day) and weekly checks (2-3 days per week b/c I cover 2-3 clinics per week). The other demand on one's time in this setting is direct oversight of many of the image guidance techniques used. Things like ExacTrac, BAT u/s, kV-kV image alignment all require real-time approval for billing purposes, so I get a steady stream of these each day as well.

Interestingly enough, cone-beam CT or MVCT do not require real-time approval, which to me is counterintuitive.

 

[medgator]

Interestingly enough, cone-beam CT or MVCT do not require real-time approval, which to me is counterintuitive.

I agree. If anything, our therapists usually can match a kv without a problem, but have some difficulty with CBCTs.

 

[GoodmanBrown]

My mix of consults and follow-ups during residency was about as Wagy described above.

So far, my days in private practice are busy, but in a different way. As a new doc, I obviously haven't built enough of a patient load to have a busy follow-up schedule, so most of my schedule is taken up with consults (2-4 per day) and weekly checks (2-3 days per week b/c I cover 2-3 clinics per week). The other demand on one's time in this setting is direct oversight of many of the image guidance techniques used. Things like ExacTrac, BAT u/s, kV-kV image alignment all require real-time approval for billing purposes, so I get a steady stream of these each day as well.

Interestingly enough, cone-beam CT or MVCT do not require real-time approval, which to me is counterintuitive.

What do you mean by this? Do you mean you have to be there when the process starts to legally bill Medicare/insurance companies? Just to document that the radiation treatment is being aimed correctly and treating the correct spot?

 

[G'ville Nole]

What do you mean by this? Do you mean you have to be there when the process starts to legally bill Medicare/insurance companies? Just to document that the radiation treatment is being aimed correctly and treating the correct spot?

Not necessarily at the machine per se, but electronic approval of these images are time stamped, and need to be logged at (or around) the time of treatment for the IGRT code (77421) to be valid. For portal images and CBCT, approval by the end of the day is sufficient. Of course, some practices (especially those without EMR) continue to play fast and loose with these requirements, but we follow it to the letter. You never know when you may get audited, and in the current climate, Medicare overbilling/fraud will not be dealt with gently, and the Costanza defense ("Was that wrong?") won't help you.

This just reflects the business/financial side of things. In practice, if anything looks funny on any of these images, the therapists will come get you. You know, in the interest of good patient care.

Wait, they don't teach this stuff in residency? Shocking, I tell you!

 

[IRISH22]

my day starts with physics or tumor boards at 7 every day...maybe a little earlier than most places. It seems like most residents get a semi-protected lunch (at least at the programs ive rotated at). residents typically leave between 4 and 5. maybe 6 or later if there is contouring to be done. I am amazed at the schedule listed by the 14 hour-day guy. But I think that was a joke...i cant believe that anyone would be lame enough to work out to an oncology mp3.

 

[RadOncZapper]

Hmm. I don't think FreakFlag was kidding about his schedule. Are you at an east coast, midwest, or west coast program, FreakFlag?
Signed,
Fearful that you are at my future program

 

[FreakFlag]

Hmm. I don't think FreakFlag was kidding about his schedule. Are you at an east coast, midwest, or west coast program, FreakFlag?
Signed,
Fearful that you are at my future program

american program. the schedule i posted is not average, but it's not the worse either. truth be told i'm actually just hovering around 60 hr/wk. outside studying and reading is extra on top of that.

 

[r90t]

8-9 Tumor boards, if no board, role in at 9.l
9-12 new patients/on tx/simx
12-1 to 130 lunch
130-TBD, senior residents 430 to 530 depending on lectures and your speed.
530+ Your board study time at home.

Private Practice
Wake up 530
Gym 630-730
800-845 admin
845-900 morning meeting
9-6 pm consults/on tx/follow ups/sims/stamping out emergencies/tumor boards/contours/tx planning/etc...and about 15 min for lunch in there.
6-645 cardio at the gym while waiting for traffic to drop off.
home by 730.

I see anywhere between 10-20 new patients/week (20 including a uro/onc clinic with 8 patient/3 hours)

Private practice=harder work than residency.

 

[Raygun77]

8-9 Tumor boards, if no board, role in at 9.l
9-12 new patients/on tx/simx
12-1 to 130 lunch
130-TBD, senior residents 430 to 530 depending on lectures and your speed.
530+ Your board study time at home.

Wow, it seems like radonc 'residents' are about as far as you can get from the 'resident of the hospital' of old!

 

[CyberKnife19]

Definitely not after residency. Even during residency, I can count on one hand (okay, maybe two) the number of days that FreakFlag describes. I suppose it all depends on your program. I know that places like MSKCC and UMich are traditionally high volume, but to consistently expect work hours like that are the exception rather than the norm.

My resident work day was:
7:30- arrive, check on consults for the day
8-9- didactics/chart rounds, depending on day of the week
9-12- consults/follow-ups/on-treats/treatment planning
12-1- lunch/tumor boards
1-4:30- more consults/follow-up/on-treats/treatment planning

Add in the fact that whenever your attending had an academic day, so did you unless you were covering for someone. Pretty benign.

Life as an attending:
7:30- arrive, check on consults for the day
8-12- consults/follow-ups/on-treats/treatment planning/approve OBI
12-1- lunch (sometimes at home!)
1-4:30 more consults/follow-ups/on-treats/treatment planning/approve OBI except Tuesday, which is my half-day.

lather, rinse, repeat. I love my job.

G'ville - I am currently training at the program that you describe above and I LOVE IT! The schedule is as described above and I feel so blessed to train under a group of attendings and with residents that are so intelligent, yet so friendly and cool.

I am glad to see that you and your family had such a nice time abroad on your recent travels. I'm sure I will be contacting you in the future soliciting advice.