Choice for away electives?

[MudPhud20XX]

Hello everyone!

I was wondering if anyone can give me some suggestions on choosing Radonc programs for my away electives after my 3rd year. Of course, before my away electives, I am doing my radonc elective at my own school.

I do have significant amount of research experiences and publications in oncology (also, in radiation oncology as well). Unfortunately, my step 1 score is about 10 pts below average, so I need to be realistic and would like to increase my chance by doing as many as away electives at perhaps less competitive places. So below are my questions and would really appreciate any feedback.

1. So I think I need to do my away electives in Radonc at less competitive programs, but I have no clue what programs are considered less competitive. Any thoughts or suggestions? Do you think doing away electives in radonc at a lesser competitive program is a good idea, if so what programs are considered less competitive?

2. How many (other than my home school's program in radonc) away electives should I be doing?

3. Will having a higher score in step 2 CK compensate my low step 1 score?

4. What other things can I do to increase my chance?

Thank you very much!
Best,

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[radoncftw]

Just to chime in, there's a ACRO webinar that the UPenn Program Director just did a few days ago talking about applying for RadOnc. It is posted in another thread and it may be helpful.

 

[redoitall]

Hello everyone!

I was wondering if anyone can give me some suggestions on choosing Radonc programs for my away electives after my 3rd year.

Hey I can't answer your questions specifically because I am like you. I just want to give you my take on my choice of aways.

I live in TX and I am lucky enough to have MD Anderson close by. Now, with my numbers, there is no way I will ever match there. However, I thought it would be a great place to go to see how it's done in one of the finest centers in the world. My expectation is to work and learn and hopefully get a letter from one of the attendings.
It is about the only away rotation I can do, so in a way, I can kind of "waste" an opportunity to perhaps go to another less competitive program with the intent of matching.

So, in the end, it all comes down to what you want to do and to setting your expectations from the get go. Then the choices are easier. I was considering maybe going to colorado or oklahoma programs to check them out, and where I would be happy to match into, but time does not allow. So I picked MD Anderson, applied and will be going in a few months.

Sorry it doesn't answer your question(s), but I just wanted to explain my reasoning to perhaps help you in some (obscure) way.

Good luck to you.

 

[MudPhud20XX]

Hey I can't answer your questions specifically because I am like you. I just want to give you my take on my choice of aways.

I live in TX and I am lucky enough to have MD Anderson close by. Now, with my numbers, there is no way I will ever match there. However, I thought it would be a great place to go to see how it's done in one of the finest centers in the world. My expectation is to work and learn and hopefully get a letter from one of the attendings.
It is about the only away rotation I can do, so in a way, I can kind of "waste" an opportunity to perhaps go to another less competitive program with the intent of matching.

So, in the end, it all comes down to what you want to do and to setting your expectations from the get go. Then the choices are easier. I was considering maybe going to colorado or oklahoma programs to check them out, and where I would be happy to match into, but time does not allow. So I picked MD Anderson, applied and will be going in a few months.

Sorry it doesn't answer your question(s), but I just wanted to explain my reasoning to perhaps help you in some (obscure) way.

Good luck to you.

Thanks for the feedback! So are you just doing one away at MD Anderson? Please keep me posted and good luck!

 

[radoncftw]

I'll add a few comments, granted I'm an MS4 applying in a few months.

from your username, it sounds like you may be a MDPhD? I think that helps significantly with the match process. It sounds like your research is oncology related. I know your step 1 score is lower, but your MD PhD with several pubs definitely may help compensate for that. You may still be competitive at upper tier programs based on your research background.

To answer your questions:
1. In terms of tiers of programs, there's a few threads on here. You can also check out doximity. For me, it seems like, there are maybe 4 overall categories:

1. The big 3 (MSKCC, MDACC, HROP) 2. The top 10-15: includes places like Penn, Stanford, Hopkins, Uchicago etc. 3. Other strongish programs: Maryland, Ohio State, Fox Chase 4. All else.

I chose to rotate at two of the Top 10ish programs and then a mid-low tier program. This has also been discussed alot on SDN. I think you have to be somewhat careful rotating at smaller programs because they take fewer residents (1-2 per year)...so your rotation there may not be that helpful if they have 1-2 internal candidates that are vying for the same spot. Another good resource is the google docs to see who matched at which programs.

2. I think it's standard to do 1 home + 2 aways (or 3 aways if you don't have a home program like me). Some do less, as the above poster is doing, and still have success. A lot depends on the strength of your home program.

3. Dr. Vapiwala said that a great CK score can help offset a poor step 1 in the webinar.

4. Clinical grades are pretty important (especially medicine / surgery) and AOA can help.

Hope some of this helps.

 

[nkmiami]

Used to be faculty at NCCN center- my suggestion: choose your program based on where you want to live, and if it has a reputation for being malignant.

How well you are trained is 95% on you/and 5% the program. Ten years after residency, it is all you. I guess if you are unmotivated or stupid, being at a place like MDACC could force basic competency down your throat, something which may not happen at smaller programs. I saw this happen with the occasional resident. Nevertheless, if you are truly interested in the field, that should not be an issue.

This is not surgery. You can always supplement any weakness with away rotations. As far as research during residency: if you are at a place like MDACC, given the resources and databases, pumping out papers is relatively easy, but with a little effort you can put out meaningless papers (retrospective reviews,SEER analyses) almost anywhere- if that is important to you.

 

[MudPhud20XX]

I'll add a few comments, granted I'm an MS4 applying in a few months.

from your username, it sounds like you may be a MDPhD? I think that helps significantly with the match process. It sounds like your research is oncology related. I know your step 1 score is lower, but your MD PhD with several pubs definitely may help compensate for that. You may still be competitive at upper tier programs based on your research background.

To answer your questions:
1. In terms of tiers of programs, there's a few threads on here. You can also check out doximity. For me, it seems like, there are maybe 4 overall categories:

1. The big 3 (MSKCC, MDACC, HROP) 2. The top 10-15: includes places like Penn, Stanford, Hopkins, Uchicago etc. 3. Other strongish programs: Maryland, Ohio State, Fox Chase 4. All else.

I chose to rotate at two of the Top 10ish programs and then a mid-low tier program. This has also been discussed alot on SDN. I think you have to be somewhat careful rotating at smaller programs because they take fewer residents (1-2 per year)...so your rotation there may not be that helpful if they have 1-2 internal candidates that are vying for the same spot. Another good resource is the google docs to see who matched at which programs.

2. I think it's standard to do 1 home + 2 aways (or 3 aways if you don't have a home program like me). Some do less, as the above poster is doing, and still have success. A lot depends on the strength of your home program.

3. Dr. Vapiwala said that a great CK score can help offset a poor step 1 in the webinar.

4. Clinical grades are pretty important (especially medicine / surgery) and AOA can help.

Hope some of this helps.

So I guess a better question for me is does anyone know which programs have a very strict step 1 cut-off score? Where can I find such information?

 

[radoncftw]

I'm not sure, possibly FREIDA? I'm not sure how accurate that is.

I don't know that programs use strict cut-offs for Rad/Onc. It seems like it is less numbers-based than Derm, Plastics, etc. That being said, I think a lot of candidates do have strong step 1 scores.

 

[redoitall]

So I guess a better question for me is does anyone know which programs have a very strict step 1 cut-off score? Where can I find such information?

Honestly I don't think you will find this info anywhere. The less stellar your extra curricular/research the stronger the step 1 score needed I suppose (although I don't know for sure). In 2014 average step 1 is 241 for the specialty, so that ball parks it for you.

Thanks for the feedback! So are you just doing one away at MD Anderson? Please keep me posted and good luck!

Yes only 1 away at MDA. I have a home program where I have to rotate as well. I don't have enough time between step 2 and interview season to add another away. So that will be it for me. It is difficult to "invest" all of my time in such competitive specialty and I remain cautious that I may not match at all in RadOnc, so I need to also care for my backup plan. I am hopeful, cautious and realistic.

No matter what you decide, good luck to you.

 

[thecarbonionangle]

My recommendation is to avoid places like MDACC. If you are competititve enough to get an interview, the rotation has potential to hurt you. If you aren't competitive to get an interview, you are only getting a letter out of it. You can go to pretty a decent place, work hard, get a letter AND an interview.

 

[redoitall]

My recommendation is to avoid places like MDACC. If you are competititve enough to get an interview, the rotation has potential to hurt you. If you aren't competitive to get an interview, you are only getting a letter out of it. You can go to pretty a decent place, work hard, get a letter AND an interview.

I absolutely agree with you there. This is an extremely important consideration and that's why one has to think long and hard where to go and do aways. I am conscious that in a way I am "wasting a bullet", as I will likely not interview there. One may think that doing a rotation just for a letter is overkill and that's justified to think so. I still think that going in one of the best centers in the world, to see how it is done and have a chance to see experts of that level work is worth "wasting that bullet". I don't know radonc as well as I would like and I hope to carry with me some of the teachings not only from the attending / residents but also the entire way it's done, the mentality, the environment etc...
So I am willing to waste my bullet for that privilege. Overkill, perhaps. For me, I am happy about this opportunity. Hopefully I will still match somewhere (and believe me that I am not looking for the best program, I am more tied in by geography (as in going in places where I can afford to live with 2 kids and my wife, hoping that she will secure a job, but not sure). Another very important aspect for me is to avoid "malignant places". I am aware that overall this away decreases my chance of matching at the other away program to which I didn't go and where my chances would have been better. However, I do not consider myself competitive for this specialty so I am applying with extreme caution, hoping for the best, expecting the worst and avoid disappointment no matter what.

 

[Krukenberg]

My recommendation is to avoid places like MDACC. If you are competititve enough to get an interview, the rotation has potential to hurt you. If you aren't competitive to get an interview, you are only getting a letter out of it. You can go to pretty a decent place, work hard, get a letter AND an interview.

I'd actually respectfully disagree with you on one point if the applicant has a strong resume. If you're a strong candidate you will get an interview but in terms of matching it's an advantage to have rotated at mdacc.


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[redoitall]

I'd actually respectfully disagree with you on one point if the applicant has a strong resume.

My recommendation is to avoid places like MDACC. If you are competitive enough to get an interview, the rotation has potential to hurt you.

Krukenberg, I don't think you are disagreeing with thecarbonionangle, just stating things differently. Saying that 1) if you are a strong candidate you can interview when you rotate is true and 2) that if you are strong candidate when you rotate you can hurt your chances by showing some limitations or simply having a bad week. Both statement are correct. I would also tend to think that if you are a strong candidate, then they might look at you a little closer because in essence it is your interview except that it is a 1 month vs 1 day interview situation, so you put yourself at risk, but you also give yourself the opportunity to demonstrate the many qualities that are not apparent on a resume and certainly never communicated by numbers.

So both your points are valid and are not mutually exclusive. And remember this are all possibilities preceded with an "if"; there is a French saying "with ifs, you could put Paris in a bottle".

 

[thecarbonionangle]

I'd actually respectfully disagree with you on one point if the applicant has a strong resume. If you're a strong candidate you will get an interview but in terms of matching it's an advantage to have rotated at mdacc.
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If one is going to get an interview, why would one rotate? If one is not going to get an interview, why would one rotate?
I guess we just look at things differently. One of the things that matters most for matching is the number of places you interview. The closer you can get to the golden 10-12 interviews the better. If you are an amazing candidate then this advise doesn't apply to you. If you are that candidate, you are set and you likely do not need to rotate. If you are the majority of "average" rad onc candidates who will not be matching at said programs, it behooves you to rotate somewhere where you have a very high chance of getting an interview.

I really do believe that doing a rotation always carries some risk. Sure it can definitely help you but you can screw up. That one bad day and someone gets a dumb impression of you and those things can always come back to hurt you. If we are speaking about someone who is going to interview there anyways, what would warrant the risk?