Overcoming regional biases in Rad Onc

[mouserat99]

We all know there is significant regional bias in the rad onc residency application process (possibly more so than many other fields), but does anyone have any tips about how to overcome this? Unfortunately the obvious answer of doing an away rotation in the area of interest will not work for my 4th year schedule due to my school's requirements and the schedule I ended up getting (it was hard enough to fit my home rad onc rotation). I have spent most of my life in the same ~100 mile radius on the East Coast but my SO is from the West Coast and desperately wants to go back to be able to spend time with an ill family member.

I have good stats (top 10 school, 260s on Step 1, mostly honors in 3rd year, AOA, 3 first-author rad onc pubs and 2-3 middle author pubs), and I feel like if I can get my foot in the door with an interview at places like UCSF, Stanford and other top West Coast places, I can let them know how much I want to be in CA, but I'm worried I won't get many interviews out there to even give me this opportunity. This is a very frustrating problem for me since the regional discrimination issue is based on applicants not usually wanting to move across the country for residency, but I actually want to.

Would it be appropriate to contact PDs after sending out my application? Should I ask my home program's chair to make some phone calls early in the application season?

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[thaddeus]

Nice stats! From what I have seen, applicants like yourself will likely get interview offers at top West Coast programs despite the regional bias. Counterintuitively, where you might have to do some legwork is at programs that, rightly or not, are perceived to be a step down (UC Davis, UCSD, UCLA, University of Washington, etc), who will look at your application and say "no way is this person coming here". My two cents would be to sit tight on the top programs and only consider contacting them if you are not hearing from them as the application season rolls on, but it may not hurt to send emails earlier to PDs at other programs you're considering on the west coast to let them know of your interest.

 

[radiaterMike]

You can also address this in your personal statement (without sounding like the only reason you want to go there is because of location). You can have different ps for different programs.

 

[lazers]

Nice stats! From what I have seen, applicants like yourself will likely get interview offers at top West Coast programs despite the regional bias. Counterintuitively, where you might have to do some legwork is at programs that, rightly or not, are perceived to be a step down (UC Davis, UCSD, UCLA, University of Washington, etc), who will look at your application and say "no way is this person coming here". My two cents would be to sit tight on the top programs and only consider contacting them if you are not hearing from them as the application season rolls on, but it may not hurt to send emails earlier to PDs at other programs you're considering on the west coast to let them know of your interest.

Umm... are you kidding? Those stats are fairly routine for "step down" programs. Radonc is a tough specialty to get into and everyone wants to go to Cali so don't worry about the program thinking you wont wanna go there because they know you do. After all it's Cali

 

[thaddeus]

I doubt these stats are "fairly routine". AOA from a top 10 school with 260+ step 1 and multiple first author rad onc pubs..... Given that there are only ~30 applicants from top 10 schools in general every year, I would suspect very few applicants have this combination of numbers, pedigree and pubs. I'm not saying that GETTING IN to these programs is routine, but these stats should buy this applicant an interview at top programs, assuming there are no other red flags (bad letters, etc).

 

[cefhcl]

Other ideas include writing a brief e-mail to PDs at a few places you are really interested in saying why you are particularly interested (and certainly an SO from the area is legit - if she's also in the match, getting the department she's interested to be really into her can help out as they can send out some emails on your behalf). Another, more risky, strategy, is that if you have a close advisor at your home school who understands your situation, asking if they have any close contacts at these schools (though this can obviously make it seem as if you aren't super interested in staying).

 

[doctorspeed]

I have the same stats as you but am West Coast trying to break into the East Coast. Let's swap?

 

[SJSM001]

Other ideas include writing a brief e-mail to PDs at a few places you are really interested in saying why you are particularly interested (and certainly an SO from the area is legit - if she's also in the match, getting the department she's interested to be really into her can help out as they can send out some emails on your behalf). Another, more risky, strategy, is that if you have a close advisor at your home school who understands your situation, asking if they have any close contacts at these schools (though this can obviously make it seem as if you aren't super interested in staying).

This. I would write a sincere email specific to each program and explain why you are, in fact, interested in moving there. Doing an away is really ideal, though, if there is any way you can fit it in- even after applications are in. The regional bias is definitely real.

 

[xrthopeful]

By all means send an email, I don't think it HURTS you at all. Just know that it's not that likely to make a difference as lots of people send emails and sincere letters of interest about a region, that it's hard for PDs to take them too seriously.

 

[Phantom1]

Those ARE pretty great stats.. 3 first author rad onc and AOA... I think you have a good chance of getting some west coast interviews. If you don't then certainly contact the PD and let them know how interested you are. Regarding UCSF remember that Mack Roach has stepped down and Hass-Kogan is leaving/left?... Stanford also recently had 1 or 2 residents leave for some reason, would take that into consideration when looking at these amazing programs. Southern California academic programs are growing fast and have great leadership. I agree there might be a window where the southern california programs might think that "no way is this person coming here"... but that will fade fast as they start matching the top applicants. Certainly having a reason to move coasts is key... saying that my girlfriend's grandma is sick will probably not be regarded that highly.. but saying that my significant other has family in the area and also has a job lined up at X Law Firm, or Y Hospital would definitely be in your favor. They want to know that there is a good chance of matching you if they rank you.. so telling them that during an interview is the way to go.

 

[itom37]

I didn't read the full thread so this may be redundant, just my take on the original poster's situation.

Great stats. Anyone who says otherwise is wrong. Just take a look at this and past years' google docs for match data (which I'll argue is biased towards those with better stats ie happy with their results and more likely to participate in the post-match data sharing). Look long and hard at your app to find out what is missing... LORs, significant volunteerism/leadership are important things. Top 10 med school does not equal top 10 rad onc department... probably not necessarily even top 25 or 50... so this is also important. Your situation regarding aways is regrettable. If there's any possibility you could work one in, try... and if not, ask your medical school what gives? I can't imagine a school not working with you on this. Anyway. If it's impossible, it's impossible.

So what can you do? Well I think you're on solid footing as is. A great app is a great app, and UCSF, Stanford, and UCSD will invite whomever they want, knowing that people will travel for what are reputed to be excellent programs. If I were you I'd write a polite 4 sentences max email to the PD's... explain what's so spectacular about their program to you and you personal situation related to wanting to be in their city. Be brief. I'd send this out about 1-2 weeks after ERAS apps have been submitted. I wouldn't call, but maybe that's just a personal thing. PD at UCSF is influx (or was at last check). PM me if you'd like to know names of whom you might contact.

That's all I'd do. You gotta accept that programs at every level (elite, strong, mid-tier, and low tier) are going to invite you and not invite you, and you'll scratch your head at why. But with your app you'll get lots of invites. I tracked my invites and nonvites on a google map for curiosity. I'm from an off brand state school, similar stats to you, and did 2 aways on the west coast. I couldn't say I got a lot of regional bias... I got non-vites from all over, and invites from all over... perhaps fewer in the Northeast than I thought, and I didn't get too many from the west coast outside of the top institutions. That's another thing... you'll typically get invites from higher tier institutions all over. Mid-tier from CA isn't going to offer you, but a top tier place tends to think they're good enough to attract talent from all over.

Hope my rambling helps.

 

[Sheldor]

I didn't read the full thread so this may be redundant, just my take on the original poster's situation.

Great stats. Anyone who says otherwise is wrong. Just take a look at this and past years' google docs for match data (which I'll argue is biased towards those with better stats ie happy with their results and more likely to participate in the post-match data sharing). Look long and hard at your app to find out what is missing... LORs, significant volunteerism/leadership are important things. Top 10 med school does not equal top 10 rad onc department... probably not necessarily even top 25 or 50... so this is also important. Your situation regarding aways is regrettable. If there's any possibility you could work one in, try... and if not, ask your medical school what gives? I can't imagine a school not working with you on this. Anyway. If it's impossible, it's impossible.

So what can you do? Well I think you're on solid footing as is. A great app is a great app, and UCSF, Stanford, and UCSD will invite whomever they want, knowing that people will travel for what are reputed to be excellent programs. If I were you I'd write a polite 4 sentences max email to the PD's... explain what's so spectacular about their program to you and you personal situation related to wanting to be in their city. Be brief. I'd send this out about 1-2 weeks after ERAS apps have been submitted. I wouldn't call, but maybe that's just a personal thing. PD at UCSF is influx (or was at last check). PM me if you'd like to know names of whom you might contact.

That's all I'd do. You gotta accept that programs at every level (elite, strong, mid-tier, and low tier) are going to invite you and not invite you, and you'll scratch your head at why. But with your app you'll get lots of invites. I tracked my invites and nonvites on a google map for curiosity. I'm from an off brand state school, similar stats to you, and did 2 aways on the west coast. I couldn't say I got a lot of regional bias... I got non-vites from all over, and invites from all over... perhaps fewer in the Northeast than I thought, and I didn't get too many from the west coast outside of the top institutions. That's another thing... you'll typically get invites from higher tier institutions all over. Mid-tier from CA isn't going to offer you, but a top tier place tends to think they're good enough to attract talent from all over.

Hope my rambling helps.

I agree with all of this, but just wanted to make an n=2 to say that I was a "top" applicant from an off-brand state school and I noticed a TON of regional bias from top tier schools. As in, I got invites from top 10 programs in the south/midwest and sort of north-east but none from the West coast. (And I am from the west coast originally!)

Honestly, its a crap shoot. Regional bias is real, and I know people raised on the west coast (me) who got nothing, people who did aways there who got nothing, and people from the midwest with no ties whatsoever that got multiple interviews. So, who knows?

 

[Neuronix]

I agree with Sheldor. Pretty much every applicant invents some reason why they must be in whatever particular location they're interviewing at that day. All sorts of often meaningless love letter like e-mails fly around between applicants and programs.

Since most people apply and play this game all over the country, location in rad onc ends up being a huge crap shoot and there's little you can do about it. I'm not saying not to play the game. You should. But in radiation oncology, you shouldn't get your hopes up or make definitive plans to be in any specific location or even region. If you hope to stay in academics, that will continue when you apply for faculty positions.

 

[ramsesthenice]

Neuronix is spot on. Its a crap shoot. Play the game if you want, it won't hurt you. But who knows what to expect. My experiences were the opposite of Sheldor and I know we were very similar applicants from a different year. I was almost categorically rejected from my non-regional mid-tier programs but got interviews at virtually all of my regional mid-tier programs. However, I got interviews at almost all of the top tier programs, with the exception of the northeast where I almost got blanked.

You have a great application and should really enjoy what is coming next year. Just go with it an try to have fun. I think you will land well.

 

[medgator]

I'm not saying not to play the game. You should. But in radiation oncology, you shouldn't get your hopes up or make definitive plans to be in any specific location or even region. If you hope to stay in academics, that will continue when you apply for faculty positions.

Ditto for PP.

 

[Neuronix]

I'd say it depends on the region for PP. There is still reasonable availability in some parts of the country. So if they line up with your desires, great! My personal experience is that for academics, things are still a total crap shoot like when I applied for residency in the first place.

 

[ramsesthenice]

I'll say it again, networking is way more important than where you train or live no matter what you want to do. I have had two department heads tell me they love my research and that I need to talk to them when I am looking for jobs. Obviously, those don't constitute job offers, but they are decent leads for this point in the game. Neither of them are in my current region.

For anyone that asks how you network...any way you can make it happen. For one of them I volunteered to be their "driver" for a couple days during a visit to our department. Got a lot of one on one time and really got to know the person. It's crazy to think that could turn out to be "the in" for my first job one day. You never know...

 

[thecarbonionangle]

does most of the networking happen in meetings? Seems like those environments are kinda click-ish/entourage-like (from what I've seen) and wouldn't lend themselves in a casual manner. I do like the angle of the driving around the visiting professor lol.

 

[ramsesthenice]

does most of the networking happen in meetings?

A lot will happen at meetings yes, but that shouldn't be the only time. Everyone is meeting a lot of people at meetings and its a little harder to stand out. Take advantage of times like when visiting professors come to your department etc. Maybe your part of a big health system that acquires smaller facilities (as everyone is doing) and they need resident help to show the new docs how use the new EMR. The more people that know you and like you the better off you are. You may not be interested in their practice, but maybe they trained where you wanted to be and would be willing to make a call for you.

 

[mouserat99]

I wanted to resurrect this thread to get any additional input from you all about whether it would be better to say something about an interest in CA at the end of my PS or whether it would be better to email PDs 2-3 weeks from submitting ERAS explaining my interest in CA?

 

[MegaVoltagePhoton]

I wanted to resurrect this thread to get any additional input from you all about whether it would be better to say something about an interest in CA at the end of my PS or whether it would be better to email PDs 2-3 weeks from submitting ERAS explaining my interest in CA?

It depends on how specific your interest in California is. Wife/Husband in same city as program? I might include that in the PS for that specific program (or programs, if there are multiple). That's a completely legit reason to rank a place #1.

But keep in mind, lots of people want to go to Cali, and a lot of people have vague "personal reasons" for being there. Reasons range from "My husband lives there" to "I've got a lot of friends there" to "My sister's ex-boyfriend's brother's booty call lives three hours away". Just saying, have something good if you're going to bring it up.