I can tell you a bit about the NCI program.
The program was started by Eli Gladstein many years ago, when he was the chairman at NCI. At that time, it was a huge program, with 4 residents per year, producing many esteemed graduates including Steve Hahn, Andrew Turrisi, and Peter Johnstone.
From the beginning, it has been a combined program with the National Naval Medical Center and Walter Reed, which have since combined into "Walter Reed Bethesda." Thus, it came to be known as the National Capital Consortium. There are also affiliate sites including Suburban Hospital, which is now part of Johns Hopkins, and others. More recently, there have been even more opportunities to spend time at other sites if you so choose.
With budget cuts, the government has become stricter in what it categorizes as an appropriate protocol patient, thus NCI has become a relatively low volume site in terms of the total number of patients on treatment. However, seven is not representative – it is typically in the high teens or 20s, which obviously isn't a lot, but it is only covered by 1 or 2 residents so it can be quite busy. NCI traditionally sees a high volume of peds, CNS, lymphoma, GI, and emergency cases. Zebras abound. There are also many consults that don't ever get treated at NCI because they aren't eligible for protocol. There are five staff that have labs and are 80:20 research.
Traditionally, half the residents have been military and the other half have been civilian. Civilian spots have not been offered through the match because it would have been a hassle to offer half through the military match and the other half through the civilian match, so they have offered the spots outside of the match.
Recently, the military has dominated the spots because they realized they needed more than they expected. Thus, there are currently 2 civilian residents with one graduating this year. There will likely be an opening for a civilian in the next match cycle. Military graduates have traditionally gone into private practice after their service obligation and civilian graduates have exclusively started in academics with the exception of the most recent graduate, who went into private practice in the greater D.C. area. Everyone has passed their boards with the exception of one person who didn't take them (close to 10 years ago). Recent civilian graduates have gone to UCLA, Penn, St Jude's, and some have stayed at NCI.
The patient volume is not low by any stretch and the lack of "bread and butter" cases is a myth. Again, NCI is only one of the sites. The NCC residency has been in the middle 3rd of all programs in terms of volume overall, but in the 90th percentile in breast and prostate. CNS, peds, and GI numbers have always been strong. Other sites can be "subsidized" with away rotations. The current PGY-3s both have nearly 400 sims.
A great bonus of the program is the full year of elective time. You can choose to spend it on clinical rotation or research, in any combination. Residents have found this valuable in allowing them to tailor their education in whatever way they think would be most valuable. Overall, the program is solid, but hasn't taken many civilians lately, causing them to go off the radar
