Is it Time to Break with ABR?

[medgator]

academic rad onc is a broad term

physician scientist with 50% clinical effort makes more sense, even 5 years in or so. 350k makes sense, depending on whether you are assistant or associate.

Sounds like he is close to ft clinically though

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[Neuronix]

Not the case at mdacc apparently

Yeah well they never wanted to hire me so I don't get to make the big bucks

 

[thecarbonionangle]

350 is a median and average income. That will probably be a good number in the future. It is hard getting a job in California. Even locums is getting to be difficult. With 25% unemployment it is 7x the median income in the US. With round 2 of Covid coming, it's probably going to get harder on the job market! We will all be happy to have one........

you heard the ASTRO president, just feel lucky you get A job. Feel lucky you even have A roof over your head

 

[scarbrtj]

Not the case at mdacc apparently

I bet $1 that the people tracking salaries don't include fellowship salaries in mean/median/etc rad onc calculations.
I also bet $1 that the people tracking unemployment include fellows as being employed as rad oncs.

 

[medgator]

you heard the ASTRO president, just feel lucky you get A job. Feel lucky you even have A roof over your head

Yup... That's the expectation...a job. And that requires networking, it won't just happen. Thanks ASTRO! Sigh

 

[RadOncLazers]

Can we refocus on the discussion of breaking from the ARB?

Clearly refusing to pay dues is one step, but how do we pull together all of the voices that need to be heard (academic leaders, private practice presidents, residents)?

We have so many exceptional people in our speciality that could help create a much more transparent, fair, and respected board. The ABR has slowly destroyed its own name - we do not need to follow them off the bridge.

 

[Radonc90]

Actually the voices are already heard.
It is unprecedented that the major org (SCAROP, ASTRO, ACR etc.) all came together and wrote a unifying letter ---> ABR.
When was the last time you saw that in the history? None.

I can sense the unhappiness (or anger) from SCAROP, ASTRO, ACR bc they see that their young grads' professional life is not taken seriously by ABR.

Actually breaking off is not a monumental undertaken, it has happened before in the history of ABMS.

The infra-structure is already there:
- The By-Laws
- The rules of governance
- The volunteers that write questions
- The volunteers as oral examiners
- The MOC system (OLA etc.)
- The annual dues

Size wise, we are the same size as neurosurgeons...That would give everyone a hint...

It is just a matter filing a divorce and move on. Life is better after divorce. We control our destiny...

 

[fiji128]

If it helps you feel better I was offered $280k recently.

25th percentile AAMC assistant professor 4 lyfe.

About 18 months ago I was offered $250K at an academic center in a desirable location with no 401K contribution as a BC rad onc. And this was a 100% clinical type of position.

 

[Tigerstang]

About 18 months ago I was offered $250K at an academic center in a desirable location with no 401K contribution as a BC rad onc. And this was a 100% clinical type of position.

Did they fill the position?

 

[Neuronix]

Did they fill the position?

I know several places that have hired at this level and even less.

 

[scarbrtj]

I know several places that have hired at this level and even less.

I remember back when rad onc Step 1 scores were carved in stone and delivered by brontosaurus, the salary levels were about the same as now.
Sad! That essentially means in real dollars rad onc salaries have gone down over time. (This makes perfect economic sense BTW.)

 

[fiji128]

Did they fill the position?

Just checking the website site now. Looks like they filled with someone who is a new grad (from at to 15'ish residency program) that went to undergraduate at the home institution. I'm somewhat familiar with the department/position as I have a local connection to the area and it basically fills with someone new every 2 to 3 years. It seemed to be a high volume low pay type of set up (with no rad onc residents) with note insignificant in patient call duties.

 

[Carotenoid]

If someone is geographically constrained, very easy to believe. Think: much of Cali (desirable areas), Boston, NYC, wouldn't surprise me if sought after southern metros with a tight job market also fell into that category.

The pick 2/3 thing has always been true and geography and salary have always been the 2 big competing factors in any job.

Can confirm: a nice metropolitan area in Cali and a "famous" academic center - offered $275K

 

[Carotenoid]

Can we refocus on the discussion of breaking from the ARB?

Clearly refusing to pay dues is one step, but how do we pull together all of the voices that need to be heard (academic leaders, private practice presidents, residents)?

We have so many exceptional people in our speciality that could help create a much more transparent, fair, and respected board. The ABR has slowly destroyed its own name - we do not need to follow them off the bridge.

yup peeps totally got off track

 

[medgator]

Can confirm: a nice metropolitan area in Cali and a "famous" academic center - offered $275K

Good luck buying a house on that, esp in NorCal

 

[RadOncLazers]

Again, the topic of the thread. What would be the next steps if we are considering a break from the ABR.

There are many other threads regarding how little we are reimbursed, young attending docs sacrificed, sky falling, etc.

 

[radoncgrad2019]

Good luck buying a house on that, esp in NorCal

have to imagine this is what GFunk offers to new PP people too in NorCal for starting salary

tough out there for a young'un

 

[Gfunk6]

have to imagine this is what GFunk offers to new PP people too in NorCal for starting salary

tough out there for a young'un

Not quite, our base salary for shareholders is significantly higher than than that and doesn't include quarterly bonuses. One thing academic centers sometimes don't understand is that if you pay someone a flat salary with no incentivization whatsoever, you get what you pay for.

 

[radoncgrad2019]

Not quite, our base salary for shareholders is significantly higher than than that and doesn't include quarterly bonuses. One thing academic centers sometimes don't understand is that if you pay someone a flat salary with no incentivization whatsoever, you get what you pay for.

Maybe salaries have gone up then. I know someone who interviewed with the group not too long ago and was told 250k starting as a first year.

 

[medgator]

Maybe salaries have gone up then. I know someone who interviewed with the group not too long ago and was told 250k starting as a first year.

$250-350k is probably as high as you'll see in most PP groups as a starting salary. Sweat equity

 

[thecarbonionangle]

$250-350k is probably as high as you'll see in most PP groups as a starting salary. Sweat equity

ya you lose the pp money the first year, most likely “total loooooooser!”

 

[evilbooyaa]

Maybe salaries have gone up then. I know someone who interviewed with the group not too long ago and was told 250k starting as a first year.

Yeah, pre-partner salaries in the 250-300 range are normal, even for a PP without technical. Difference is in a PP when you become a partner (or shareholder) it shoots up, while in academics it will essentially be the same (maybe) until you hit associate prof.

 

[radoncgrad2019]

Yeah, pre-partner salaries in the 250-300 range are normal, even for a PP without technical. Difference is in a PP when you become a partner (or shareholder) it shoots up, while in academics it will essentially be the same (maybe) until you hit associate prof.

Yes I understand this. I was directly refuting GFunks claim

 

[medgator]

Maybe salaries have gone up then. I know someone who interviewed with the group not too long ago and was told 250k starting as a first year.

You aren't a shareholder when you start.

 

[Phantom1]

So if you are already ABR board certified in Rad Onc and you stop paying your dues, what is the actual consequence short term and long term? Any billing implications?

 

[thecarbonionangle]

Nobody seems to be able to know what needs to happen to break off? Keep conversation on track please

 

[seper]

ABR will probably send you a notification that you're not meeting MOC. Then, you can't mark "board certified" when you apply for hospital privileges.

So if you are already ABR board certified in Rad Onc and you stop paying your dues, what is the actual consequence short term and long term? Any billing implications?

 

[Chartreuse Wombat]

Unless you have a time unlimited certificate. 1994 and before.

 

[medgator]

Unless you have a time unlimited certificate. 1994 and before.

Boomers4Lyfe

 

[RadOncLazers]

Which other specialty has broken off? It might be helpful to investigate the route and steps they took.

 

[thecarbonionangle]

Which other specialty has broken off? It might be helpful to investigate the route and steps they took.

plastic surgery
IR

Like a lot of the now independent surgery boards

 

[Carotenoid]

plastic surgery
IR

Like a lot of the now independent surgery boards

I am all for breaking off!

 

[RadOncLazers]

Does anybody know leadership for plastic surgery or IR who works with / for their overseeing board?

Might be worthwhile discussing a course of action.

 

[GapCalc]

THE Mike Steinberg has some Big Deal Opinions about this topic (and this is from ROHub, but that place is basically North Korea so here are some screenshots via Twitter).

The highlights:
1) Stop being so mean to Paul Wallner, DO!!!
2) The decision by ABR to do virtual exams has nothing to do with the uproar by literally everyone in the RO and rads community
3) Hand-waving about trust from "the public" and Angoff methods and how 80 staff members are needed to certify ~200 residents a year
4) Falling interest in the specialty predated 2018 board exams, so... we need to find out why students don't want pursue RO [Ed: job market?]
5) "Anonymous student blogs" are a problem [is SDN a blog?]

 

[evilbooyaa]

Steinberg with the stereotypical, old white man circling of the wagons in response to 1) valid criticisms of the board and 2) a repudiation of another old white man doing insensitive **** that old white men (or really any group) can no longer get away with in the current era.

Old white men are going to old white man is my overall response to this.

It's a lot of words that just goes "I DONT LIKE CHANGE LALALALALA" with fingers in the ears.

Sometimes our oldest members are simultaneously the most childish. Surprised that UCLA is still rocking the "crotchety old white male" stereotype as their chair.

 

[scarbrtj]

"A prominent radiation oncologist just said the ~5000 practicing radiation oncologists in the US aren't a big enough group to have their own fully functioning and well-respected specialty board." - The ~3700 members of the American Board of Neurological Surgeons

"If you're explaining, you're losing." - Ronald Reagan

FINALLY...
"I do not have a time limited certificate, but I do participate in all aspects of MOC."
NO.
This is the ultimate non sequitur when you really think about it. You do not participate in the part where there are ramifications of failing in MOC requirements, so you do not participate in all aspects... you exclude yourself from the most important aspect: punishment. It's like a cancer cell saying "I have genes that allow me to replicate indefinitely, but I still maintain all the other normal genes that don't." Or worse: "I live in a racist society, but all of my friends are black."

 

[Mandelin Rain]

Has "the public" ever questioned the credibility of a board (other than perhaps when the radiologists were caught cheating on the ABR)?

I don't want my dues funding the ABR's defense against radiologists.

Too much baggage. Severe ties.

 

[thecarbonionangle]

It is a very interesting post by Dr Steinberg. Let us break it down:

1) he comes to the defense of his fellow fat cat corrupt buddy at 21C oncology. Both have made millions, selling out pps to greedy people
2) he gets paid 1 million to be chair, probably feels the pitchforks poking his butt
3) he holds an unlimited certificate but certainly feels you should be held to a different standard
4) the ABR is a bloated bureaucracy with tons of fat cats which would lose their jobs if we break away. Do we really need that much lard?

what we have is an entrenched white man coming to the defense of a system that actively empowers him. He goes to the secret handshake country club and eats Paul Wallner’s Kentucky derby pie and his mom’s “closely guarded” chocolate mint brownies. He sees the current discussion as a threat to himself, his buddies and the system that empowers them and will actively work to crush any dissenters.

the wagons are circling. The best is yet to come.

 

[scarbrtj]

It's a lot of words that just goes "I DONT LIKE CHANGE LALALALALA" with fingers in the ears.

He sees the current discussion as a threat to himself, his buddies and the system that empowers them and will actively work to crush any dissenters.

the wagons are circling. The best is yet to come.

Riots, chaos, and mobs on ROhub and SDN

 

[Lamount]

Ahhh, this guy says the ABR is perfect and anyone who says otherwise is "fake news". He knows his audience: highly educated people tend to respect and adore a bully who claims to be a victim

 

[OTN]

His use of "ad hominem attack" bothered me as well. It's not an ad hominem attack. He's just being attacked for being an out-of-touch jerk, on this and other "anonymous student blogs."

TL;DR ok boomer

 

[elementaryschooleconomics]

It is a very interesting post by Dr Steinberg. Let us break it down:

1) he comes to the defense of his fellow fat cat corrupt buddy at 21C oncology. Both have made millions, selling out pps to greedy people
2) he gets paid 1 million to be chair, probably feels the pitchforks poking his butt
3) he holds an unlimited certificate but certainly feels you should be held to a different standard
4) the ABR is a bloated bureaucracy with tons of fat cats which would lose their jobs if we break away. Do we really need that much lard?

what we have is an entrenched white man coming to the defense of a system that actively empowers him. He goes to the secret handshake country club and eats Paul Wallner’s Kentucky derby pie and his mom’s “closely guarded” chocolate mint brownies. He sees the current discussion as a threat to himself, his buddies and the system that empowers them and will actively work to crush any dissenters.

the wagons are circling. The best is yet to come.

I demand a podcast with Wallner, Steinberg, and Weichselbaum. We could call it "Old Men Yell at Clouds". There could be a rotating 4th chair of younger, more progressive docs for them to demean and belittle. Season 1, Episode 1: "How can we increase diversity in Radiation Oncology". Instant hit.

 

[thecarbonionangle]

What exactly was the removed ROHUB post he referenced which sparked the official ASTRO doctrine of “you better stfu or we will crush you, pulverize you. Be “professional”” ? Did anybody catch it?

 

[scarbrtj]

What exactly was the removed ROHUB post he referenced which sparked the official ASTRO doctrine of “you better stfu or we will crush you, pulverize you. Be “professional”” ? Did anybody catch it?

I did. By a guy who's first name is short for "simulation"
It was a totally reasonable post, as usual.

 

[Mandelin Rain]

Students considering UCLA as a residency, read his comments closely and ask yourself, "what happens if I disagree with something/anything during my residency?".

 

[BobbyHeenan]

I would gladly put the fate of my career and the field in the hands of Shah and Simul before any Chair I can think of off the top of my head.

 

[seper]

His salary at UCLA is envious. Wallner’s stipend at ABR is meh


Sent from my iPhone using Tapatalk

 

[Gfunk6]

It looks like Steinberg's post on ROHUB was deleted? Thanks for capturing it with screen shots

 

[evilbooyaa]

Appears ROHub might be deleting some posts? Shows these posts in the preview area, but when you click on the thread itself, the 3 posts noted here are no-where to be found.

This is your friendly reminder that at SDN, all opinions are welcome, and we will not gaslight those who have a differing opinion of us of being menaces and thus delete all your posts. Those who have had posts deleted at ROHub, we would be happy to discuss the merits of your thoughts on SDN in further detail if you would like to continue the discussion.

 

[scarbrtj]

ROHub... where the brazen effrontery of offending others' delicate sensibilities is now met with the most "professional" of responses:
censorship.