Programs that have increased/decreased resident numbers and closed 2019 to 2024

[fiji128]

Programs that have closed with approved resident spots prior to withdrawal of accreditation; Drexel in 2019 (4), Medical College of Georgia in 2019 (4), California Pacific in 2019 (4) Cornell 2021 (6), NCI in 2023 (6) and University of Tennessee in 2024 (4).

Programs to have officially increased spots from 2019 to 2021; Loma Linda 5 to 6, Case Western Reserve 6 to 7, Columbia 6 to 8, Northwestern 8 to 9, Thomas Jefferson 9 to 11, Duke 13 to 14. 2023 to 2024 Mt Sinai 10 to 11.

Programs to have officially increased spots from 2021 to 2022 and from 2022 to 2023; None.

Programs to have officially decreased spots from 2021 to 2022; None. From 2022 to 2023 MDACC officially decreased it training compliment from 28 to 24.

List from ACGME with search done on 4/26/2024 and previously on 4/6/2023, 3/7/2022, 2/23/2021 and 3/14/2019.

ACGME - Accreditation Data System (ADS)

ACGME data on this list was listed as effective as of 1/10/2024.



Dartmouth est 2018. 4 resident positions in 2019 and 4 in 2024.
University of Arkansas est 2017. 4 resident positions in 2019 and 4 in 2024.
West Virginia University est 2016. 4 resident positions in 2019 and 4 in 2024. Currently with 2 total residents enrolled.
Stony Brook est 2016. 4 resident positions in 2019 and 4 in 2024.
University of Tennessee est 2015. 4 resident positions in 2019 and 4 in 2023. 3 total residents enrolled in 2023. Accreditation Status Voluntarily withdrawn 6/30/2024.
Drexel est 2014. 4 resident positions with accreditation withdrawn in 2019.
Medical College of Georgia est 2013. 4 resident positions with accreditation withdrawn 2019.
Cedars Sinai est 2013. 4 resident positions in 2019 and 4 in 2024.
Mayo Clinic Arizona est 2013. 4 resident positions in 2019 and 4 in 2024. Currently with 3 total residents enrolled.
University of Nebraska est 2010. 4 resident positions in 2019 and 4 in 2024.
University of Mississippi est 2010. 4 resident positions in 2019 and 4 in 2024. Currently with 3 total residents enrolled.
Mayo Clinic Jacksonville est 2005. 4 resident positions in 2019 and 4 in 2024.
Allegheny Health Network est 1994. 4 resident positions in 2019 and 4 in 2024. Currently with 2 total residents enrolled.
California Pacific Medical Center est 1973. 4 resident positions with accreditation withdrawn in 2019.
University of California Irvine est 1978. Don’t have 2019 resident numbers and 5 in 2021 and 5 in 2024.
Brooklyn Methodist est 1974. 5 resident positions in 2019 and 5 in 2024. Currently with 4 total residents enrolled.
University of Texas Medical Branch est 1972. 5 resident positions in 2019 and 5 in 2024. Currently with 3 total residents enrolled.
Loma Linda est 1973. 5 resident positions in 2019, 6 in 2021 and 6 in 2024.
City of Hope est 2008. 6 resident positions in 2019 and 6 in 2024.
University of Oklahoma est 2007. 6 resident positions in 2019 and 6 in 2023. Currently 5 total residents enrolled. Continued accreditation with warning.
Cornell est 1995 6 resident positions with accreditation withdrawn 2021.
University of Kentucky est 1994. 6 resident positions in 2019 and 6 in 2024.
University of Buffalo est 1993. 6 resident positions in 2019 and 6 in 2024.
National Capital Consortium est 1981. 6 resident positions in 2019 and 6 in 2023. The NCI voluntarily withdrew accreditation effective 6/30/2023.
Georgetown est 1981. 6 resident positions in 2019 and 6 in 2024.
University of Kansas est 1977. 6 resident positions in 2019 and 6 in 2024.
University of Texas San Antonio est 1976. 6 positions in 2019 and 6 in 2024.
University of Virginia est 1972. 6 resident positions in 2019 and 6 in 2024.
Henry Ford est 1972. 6 resident positions in 2019 and 6 in 2024.
SUNY Upstate est 1971. 6 resident positions in 2019 and 6 in 2024. Temporary Increase of 1 effective 7/1/2025 to 1/31/2026.
Oregon Health and Science University est 1970. 6 resident positions in 2019 and 6 in 2024.
University of Minnesota est 1970. 6 resident positions in 2019 and 6 in 2024.
University of Louisville est 1969. 6 resident positions in 2019 and 6 in 2024.
Rush est 1969. 6 resident positions in 2019 and 6 in 2024.
Case Western Reserve est 2000. 6 resident positions in 2019, 7 in 2021 and 7 in 2024. Currently 6 total residents enrolled. Continued Accreditation with Warning.
University of California Davis est 2004. 7 resident positions in 2019 and 7 in 2024.
University of Iowa est 1977. Don’t have 2019 resident number 7 in 2021 and 7 in 2024. Continued Accreditation with Warning.
Medical University of South Carolina est 1976. 7 resident positions in 2019 and 7 in 2024. Currently 6 total residents enrolled.
University of Arizona est 1973. 7 resident positions in 2019 and 7 in 2024. Currently 6 total residents enrolled.
Wake Forrest est 1971. 7 resident positions in 2019 and 7 in 2024. Currently 6 total residents enrolled.
Albert Einstein est 1970. 7 resident positions in 2019 and 7 in 2024.
University of Southern California est 1970. 7 resident positions in 2019 and 7 in 2024.
Hofstra/Northwell est 2012. 8 resident positions in 2019 and 8 in 2024. Currently with 7 total residents enrolled.
Texas A and M est 2011. 8 resident positions in 2019 and 8 in 2024. Currently 1 total residents enrolled.
University of Colorado est 2003. 8 resident positions in 2019 and 8 in 2024. Currently 7 total residents enrolled.
University of Pittsburgh est 2001. 8 resident positions in 2019 and 8 in 2024.
Kaiser Permanente Los Angeles est 1985. 8 resident positions in 2019 and 8 in 2024.
Baylor College of Medicine est 1981. 8 resident positions in 2018 and 8 in 2024. Temporary Increase of 1 effective 7/1/2024 to 6/30/2028.
Medical College of Wisconsin est 1974. 8 resident positions in 2019 and 8 in 2024.
Loyola est 1974. 8 resident positions in 2019 and 8 in 2024. Currently 7 total residents enrolled.
Wayne State est 1973. 8 resident positions in 2019 and 8 in 2024. Currently 7 total residents enrolled.
University of North Carolina est 1973. 8 resident positions in 2019 and 8 in 2024.
University of Wisconsin est 1973. 8 resident positions in 2019 and 8 in 2024.
Columbia est 1973. 6 resident positions in 2019, 8 in 2021 and 8 in 2024. Currently 7 total residents enrolled.
University of Cincinnati est 1972. 8 resident positions in 2019 and 8 in 2024. Currently 7 total residents enrolled.
University of Rochester est 1971. 8 resident positions in 2019 and 8 in 2024.
Virginia Commonwealth University est 1969. 8 resident positions in 2019 and 8 in 2024. Currently 7 total residents enrolled.
SUNY Downstate est 1969. 8 resident positions in 2019 and 8 in 2024. Currently 5 total residents enrolled.
Rutgers est 2005. 9 resident positions in 2019 and 9 in 2024. Currently 8 total residents enrolled.
Fox Chase est 1992. 9 resident positions in 2019 and 9 in 2024.
Indiana University est 1976. 9 resident positions in 2019 and 9 in 2024. Currently 7 total residents enrolled.
Northwestern University est 1972. 8 resident positions in 2019, 9 in 2021 and 9 in 2024. Currently 8 total residents enrolled.
Tufts est 1971. 9 resident positions in 2019 and 9 in 2024. Currently 7 total residents enrolled.
University of Florida est 1969. 9 resident positions in 2019 and 9 in 2024. Currently 8 total residents enrolled.
University of South Florida/Moffitt est 2007. 10 resident positions in 2019 and 10 in 2024.
Vanderbilt est 2001. 10 resident positions in 2019 and 10 in 2024.
University of Utah est 1972. 10 resident positions in 2019 and 10 in 2024. Currently 8 total residents enrolled.
New York University est 1971. 10 resident positions in 2019 and 10 in 2023.
Ohio State University est 1971. 10 resident positions in 2019 and 10 in 2024.
University of Washington est 1970. 10 resident positions in 2019 and 10 in 2024.
Mount Sinai est 1991. 10 resident positions in 2019 and 10 in 2023. 11 in 2024. Currently 10 total residents enrolled.
Thomas Jefferson est 1973. 9 resident positions in 2019, 11 in 2022, and 11 in 2024. Currently 9 total residents enrolled. Temporary Increase of 1 from 2019 to 2024.
University of Michigan est 1971. 11 resident positions in 2019 and 11 in 2024.
University of California San Diego est in 2010. 12 resident positions in 2019 and 12 in 2024.
University of Chicago est 1985. 12 resident positions in 2019 and 12 in 2024.
Cleveland Clinic est 1974. 12 resident positions in 2019 and 12 in 2024. Currently 11 total residents enrolled.
Beaumont est 1974. 12 resident positions in 2019 and 12 in 2024. Currently 11 total residents enrolled.
University of Maryland est 1973. Don’t have 2019 resident number and 12 in 2021 and 12 in 2024. Currently 11 total residents enrolled.
University of Miami est 1973. 12 resident positions in 2019 and 12 in 2024. Currently 10 total residents enrolled.
University of Alabama est 1973. 12 resident positions in 2019 and 12 in 2024.
Mayo Clinic Rochester est 1972. 12 resident positions in 2019 and 12 in 2024. Temporary increase of 1 effective 7/1/2023 to 6/30/2026. Currently 13 total residents enrolled.
University of California Los Angeles est 1970. 12 resident position in 2019 and 12 in 2024.
University of California San Francisco est 1971. 13 resident positions in 2019 and 13 in 2024.
Duke University est 1969. 13 resident positions in 2019, 14 in 2021 and 14 in 2024. Temporary increase to 15 from 7/1/2023 to 6/30/2026. Currently 15 total residents enrolled.
University of Texas Southwestern est 2005. 14 in 2019 and 14 in 2024. Currently 13 total residents enrolled.
Yale est 1969. 14 resident positions in 2019 and 14 in 2024.
Emory est 1993. 16 resident positions in 2019 and 16 in 2024. Currently 15 total residents enrolled.
John Hopkins est 1974. 16 resident positions in 2019 and 16 in 2023.
Washington University est 1971. 16 resident positions in 2019 and 16 in 2023. Temporary increase to 17 from 2023 to 2024. Currently 16 total residents enrolled.
Stanford est in 1970. 17 resident positions in 2019 and 17 in 2024.
University of Pennsylvania est 1973. 18 resident positions in 2019 and 18 in 2024.
Memorial Sloan Kettering est 1971. 24 positions in 2019 and 24 in 2024.
MD Anderson est 1970. 28 resident positions in 2019 and 28 in 2022 and 24 in 2023. 24 in 2024.
Harvard Combined Program est 2002. 30 resident positions in 2019 and 30 in 2024. Currently 26 total residents enrolled.

---

Members don't see this ad.

 

[fiji128]

12 programs with 4 resident training positions
3 programs with 5 resident training positions
15 programs with 6 resident training positions
8 programs with 7 resident training positions
16 programs with 8 resident training positions
6 programs with 9 resident training positions
6 programs with 10 resident training positions
3 programs with 11 resident training positions
9 programs with 12 resident training positions
1 program with 13 resident training positions
3 programs with 14 resident training positions
3 programs with 16 resident training positions
1 program with 17 resident training positions
1 program with 18 resident training positions
2 programs with 24 resident training positions
1 program with 30 resident training positions

For a total of 808 potential resident training positions in starting in July 2024.

811 training position for this academic year. 51 total net positions unfilled leaving 760 total trainees for 2023-2024.

 

[elementaryschooleconomics]

Programs to have officially increased spots from 2019 to 2021; Loma Linda 5 to 6, Case Western Reserve 6 to 7, Columbia 6 to 8, Northwestern 8 to 9, Thomas Jefferson 9 to 11, Duke 13 to 14. 2023 to 2024 Mt Sinai 10 to 11.

When reached for comment, asking for some sort of explanation behind such unethical behavior, the Chairs of these programs all responded, in unison, in a creepy monotone:

"WE HAVE SEEN AN INCREASE IN OUR PATIENT VOLUME WHICH JUSTIFIES OUR EXPANSION. WE PROVIDE EXCELLENT TRAINING AND DO NOT BELIEVE WE SHOULD DEPRIVE RESIDENTS OF THE OPPORTUNITY TO TRAIN HERE. IT'S THE BAD PROGRAMS WHO SHOULD CUT SPOTS. THE BAD PROGRAMS. YOU KNOW THE ONES."

 

[seper]

thanks for the important work fiji

 

[taserlaser]

Wow you guys down south are training like 3.5x the amount of rad oncs per capita as us up North right now.
Canada 2024 match: 25 spots, all filled (24 in first round), population 39 million, ~0.6 RO resident per million
US 2024 match: 808 spots, 760 filled, population 341 million, ~2.2 RO resident per million

2.2/0.6 = ~3.5x rate of training

Yikes

 

[thecarbonionangle]

It is so maddening to read this. Multiple total hellpits expanded. Some it is supposedly “temporary”. This field is absolutely doomed when MD Anderson/NCI is cutting spots while hellpit warm body loving places expand.

 

[medgator]

When reached for comment, asking for some sort of explanation behind such unethical behavior, the Chairs of these programs all responded, in unison, in a creepy monotone:

"WE HAVE SEEN AN INCREASE IN OUR PATIENT VOLUME WHICH JUSTIFIES OUR EXPANSION. WE PROVIDE EXCELLENT TRAINING AND DO NOT BELIEVE WE SHOULD DEPRIVE RESIDENTS OF THE OPPORTUNITY TO TRAIN HERE. IT'S THE BAD PROGRAMS WHO SHOULD CUT SPOTS. THE BAD PROGRAMS. YOU KNOW THE ONES."

Nothing about the faculty salaries being too high? That actually was a complaint published in our esteemed journal

 

[NotMattSpraker]

Nothing about the faculty salaries being too high? That actually was a complaint published in our esteemed journal

If this frustrates you, like me, you might be interested in this new website from feds.

Help us ensure access to fair and competitive healthcare markets for you and your family.

www.justice.gov

 

[Neuronix]

If this frustrates you, like me, you might be interested in this new website from feds.

Help us ensure access to fair and competitive healthcare markets for you and your family.

www.justice.gov

 

[elementaryschooleconomics]

If this frustrates you, like me, you might be interested in this new website from feds.

Help us ensure access to fair and competitive healthcare markets for you and your family.

www.justice.gov

If anyone is afraid of "going first" or "being the only one"...

Your anxiety is unfounded.

[insert awkward winking here]

 

[DrProtonX]

12 programs with 4 resident training positions
3 programs with 5 resident training positions
15 programs with 6 resident training positions
8 programs with 7 resident training positions
16 programs with 8 resident training positions
6 programs with 9 resident training positions
6 programs with 10 resident training positions
3 programs with 11 resident training positions
9 programs with 12 resident training positions
1 program with 13 resident training positions
3 programs with 14 resident training positions
3 programs with 16 resident training positions
1 program with 17 resident training positions
1 program with 18 resident training positions
2 programs with 24 resident training positions
1 program with 30 resident training positions

For a total of 808 potential resident training positions in starting in July 2024.

811 training position for this academic year. 51 total net positions unfilled leaving 760 total trainees for 2023-2024.

I think the best way to start the reduction would be to go from total resident model to per year. Programs with 5,6,7 residents should go down to 4. Programs with 9,10,11 to 8 and so forth.

 

[NotMattSpraker]

I think the best way to start the reduction would be to go from total resident model to per year. Programs with 5,6,7 residents should go down to 4. Programs with 9,10,11 to 8 and so forth.

I'd love to be wrong but I dont think we will get any reduction. Even if all PDs came to their senses tomorrow morning, there are a ton of barriers and some money involved.

There is a decent IJROBP podcast with Shaun Loewen from Canada where he talks about how they did a reduction. It took a lot of altruism and analysis and thought, and we are the US... so...

 

[taserlaser]

I'd love to be wrong but I dont think we will get any reduction. Even if all PDs came to their senses tomorrow morning, there are a ton of barriers and some money involved.

There is a decent IJROBP podcast with Shaun Loewen from Canada where he talks about how they did a reduction. It took a lot of altruism and analysis and thought, and we are the US... so...

Big fan of Shaun and his work. Think he just got a big grant to for more human resource studies in Canadian oncology.

 

[temujim]

12 programs with 4 resident training positions
3 programs with 5 resident training positions
15 programs with 6 resident training positions
8 programs with 7 resident training positions
16 programs with 8 resident training positions
6 programs with 9 resident training positions
6 programs with 10 resident training positions
3 programs with 11 resident training positions
9 programs with 12 resident training positions
1 program with 13 resident training positions
3 programs with 14 resident training positions
3 programs with 16 resident training positions
1 program with 17 resident training positions
1 program with 18 resident training positions
2 programs with 24 resident training positions
1 program with 30 resident training positions

For a total of 808 potential resident training positions in starting in July 2024.

811 training position for this academic year. 51 total net positions unfilled leaving 760 total trainees for 2023-2024.

Close every program with less than 8 positions. Slices off 209 positions.

 

[TheWallnerus]

Wow you guys down south are training like 3.5x the amount of rad oncs per capita as us up North right now.


Yikes

/sarcasm

We did not know that

/sarcasm

 

[drowsy12]

Americans don’t want to travel.

If we want concentrated centralized centers like Canada, our landscape would look very different.

 

[TheWallnerus]

Anyone have any scuttlebutt on U Tennessee voluntary withdrawal of accreditation.

I just think it is so sh**ty to open up a program, accept residents, and shut it down a few years later. Can we blame the tulip mania of peak rad onc?

 

[medgator]

Anyone have any scuttlebutt on U Tennessee voluntary withdrawal of accreditation.

I just think it is so sh**ty to open up a program, accept residents, and shut it down a few years later. Can we blame the tulip mania of peak rad onc?

I'll take it!!!

You think anyone who matched into UT a few years ago didn't expect this might happen? These are marginal unnecessary programs

 

[NotMattSpraker]

Americans don’t want to travel.

If we want concentrated centralized centers like Canada, our landscape would look very different.

Thats why if you have any kind of respect for this noble profession you have to really convince them to travel far away to your center because its definitely better for your very routine T1N0M0 breast cancer.

Seriously, Im not sure what you mean by that?

 

[drowsy12]

What I mean is that part of the reason we will inherently have more rad oncs per capita (not saying it should be 3x!) is the economics of hospital based payments make it so that smaller centers can survive with ten on beam, and that centers need to exist in places that maybe in Canada wouldn’t exist because the centers there (and Europe) are centralized.

With the way rad onc is practiced in the US currently, with the vast majority of centers having docs on site all the time, and the system mentioned above, we will have more Linacs and rad oncs per capita than Canada and Europe.

 

[taserlaser]

What I mean is that part of the reason we will inherently have more rad oncs per capita (not saying it should be 3x!) is the economics of hospital based payments make it so that smaller centers can survive with ten on beam, and that centers need to exist in places that maybe in Canada wouldn’t exist because the centers there (and Europe) are centralized.

With the way rad onc is practiced in the US currently, with the vast majority of centers having docs on site all the time, and the system mentioned above, we will have more Linacs and rad oncs per capita than Canada and Europe.

oh for sure. Would not even close to expect it being the same. 3x is a fair amount and just surprising to me based off of the napkin math. No idea how that number compares to other specialties though and may actually be appropriate in the right context. Who knows! Someone can look it up or maybe if I get bored later lol

 

[ramsesthenice]

Close every program with less than 8 positions. Slices off 209 positions.

Not coming at you personally, but this kind of mentality is part of the easy out that keeps serious discussions from ever happening. Chairs at the large programs can pay lip service to the idea that we would cut spots but suggest it shouldn’t be them because they have the resources and leaders to properly train the next generation. Smaller centers argue the big places should cut to maintain thought diversity and not train 80% of our trainees at 5 programs. It doesn’t matter…the only cuts that could ever happen are forced cuts from above. Even if a chair sincerely wanted to reduce their compliment, their Dean will argue it’s a bad look for the SOM and probably wouldn’t approve it.

In my crazy mind, the simplest formula is that the only possible numbers are 4, 8, or 12. Have to have at least 2.5-3x as many full time clinical faculty on main campus. Minimum of 10 clinical faculty to have a small program. No more of this adding 1-2 spots “because we can” BS or deciding that because you have 60 faculty, you should amass a small army of residents.

 

[taserlaser]

Seems to me you should just have a battle royale. Some ideas:
One big squid game
Paintball
Pin the tail on the linac

 

[Barcelona PSG]

The new ACGME rules require programs to have a complement of 1.5 to 1 faculty-to-resident ratio in radiation oncology. I know at least a couple of programs that have a resident complement of 8, but due to these rules, have cut down to 6 spots. We will further know the full extent of how these rules impact the residency spots from the next match cycle.

 

[thecarbonionangle]

Seems to me you should just have a battle royale. Some ideas:
One big squid game
Paintball
Pin the tail on the linac

SCAROP crew most def “VIPs”. These are sick people!

 

[CurbYourExpectations]

 

[Gfunk6]

The new ACGME rules require programs to have a complement of 1.5 to 1 faculty-to-resident ratio in radiation oncology. I know at least a couple of programs that have a resident complement of 8, but due to these rules, have cut down to 6 spots. We will further know the full extent of how these rules impact the residency spots from the next match cycle.

Junior “faculty” in name only who work in satellites in Bumble****, USA should only count as 0.1 faculty for the purposes of determining resident complement.

 

[ramsesthenice]

Junior “faculty” in name only who work in satellites in Bumble****, USA should only count as 0.1 faculty for the purposes of determining resident complement.

I’ll go a step further. They count for nothing, and if teaching faculty at main are expected to cover satellites, each satellite counts as -1 against the faculty total for residency purposes.

 

[ivybme]

12 programs with 4 resident training positions
3 programs with 5 resident training positions
15 programs with 6 resident training positions
8 programs with 7 resident training positions
16 programs with 8 resident training positions
6 programs with 9 resident training positions
6 programs with 10 resident training positions
3 programs with 11 resident training positions
9 programs with 12 resident training positions
1 program with 13 resident training positions
3 programs with 14 resident training positions
3 programs with 16 resident training positions
1 program with 17 resident training positions
1 program with 18 resident training positions
2 programs with 24 resident training positions
1 program with 30 resident

I think the best way to start the reduction would be to go from total resident model to per year. Programs with 5,6,7 residents should go down to 4. Programs with 9,10,11 to 8 and so forth.

Just doing the math:

38 programs with 4-7 residents = 152 residents or 38/year if contracted to 4 residents
31 programs with 8-11 residents = 248 residents or 62/year if contracted to 8 residents
13 programs with 12-14 residents = 156 residents or 39/year if contracted to 12 residents
5 programs with 16-18 residents = 80 residents or 20/year if contracted to 16 residents
3 programs with 24-30 residents = 72 residents or 18/year if contracted to 24 residents

38+62+39+20+18 = 177 residents/year
Which would reduce it somewhat but not completely to the 120 number that many have suggested
If we cut out all programs with less than 7 residents it would get the number down to 139 residents/year which would be much closer.

 

[radiation123]

Wow you guys down south are training like 3.5x the amount of rad oncs per capita as us up North right now.
Canada 2024 match: 25 spots, all filled (24 in first round), population 39 million, ~0.6 RO resident per million
US 2024 match: 808 spots, 760 filled, population 341 million, ~2.2 RO resident per million

2.2/0.6 = ~3.5x rate of training

Yikes

The 808 number is total number of spots per the 4 years of residence. So the yearly number of matched radonc spots available is closer to 202 for the US. So I think the rad oncs trained per capita is pretty close.

 

[DrProtonX]

While

Just doing the math:

38 programs with 4-7 residents = 152 residents or 38/year if contracted to 4 residents
31 programs with 8-11 residents = 248 residents or 62/year if contracted to 8 residents
13 programs with 12-14 residents = 156 residents or 39/year if contracted to 12 residents
5 programs with 16-18 residents = 80 residents or 20/year if contracted to 16 residents
3 programs with 24-30 residents = 72 residents or 18/year if contracted to 24 residents

38+62+39+20+18 = 177 residents/year
Which would reduce it somewhat but not completely to the 120 number that many have suggested
If we cut out all programs with less than 7 residents it would get the number down to 139 residents/year which would be much closer.

While theoretically that might be a better idea since some of those smaller programs are questionable (I interviewed at a program that did not have brachy!), it would be really hard to justify closing a program when they’re the only rad onc program in the state.

 

[medgator]

While

While theoretically that might be a better idea since some of those smaller programs are questionable (I interviewed at a program that did not have brachy!), it would be really hard to justify closing a program when they’re the only rad onc program in the state.

Why would that be hard? Need appropriate training, full stop. We don't have an undersupply problem, we have a Maldistribution one.

That's an excuse to allow recently created programs with poor training to keep pumping out ROs we don't need, societally

 

[DrProtonX]

Why would that be hard? Need appropriate training, full stop. We don't have an undersupply problem, we have a Maldistribution one.

That's an excuse to allow recently created programs with poor training to keep pumping out ROs we don't need, societally

Because I highly doubt you can convince any chair to close their program because “it’s not good enough” no matter how true that might be without any comparable measures. Also from personal experience, bigger doesn’t always mean better. I inverviewed at some places with 10-12 residents and the residents seemed very overworked and miserable, at least during the interview it felt like a very toxic environment. On the other hand, there were bunch of programs with 4-8 residents which residents looked super happy with the program and where they were. Obviously I can’t comment on the “quality” of the training they were getting at any of those places. At the end, I think the required case number and faculty-to-resident ratio should increase so programs without sufficient volume and faculty end up closing. But as I mentioned before, I’m very new to rad onc so I don’t know how possible these changes would be!

 

[MidwestRadOnc]

I inverviewed at some places with 10-12 residents and the residents seemed very overworked and miserable, at least during the interview it felt like a very toxic environment.

TJ?

 

[DrProtonX]

TJ?

Not TJ, but I’ve heard that place has a bad reputation. Don’t really know much about since I didn’t even apply there.

 

[CurbYourExpectations]

Why would that be hard? Need appropriate training, full stop. We don't have an undersupply problem, we have a Maldistribution one.

That's an excuse to allow recently created programs with poor training to keep pumping out ROs we don't need, societally

There is evidence that smaller programs are more likely to supply the areas of maldistribution than the bigger ones. Big name programs in big name cities are more likely to send to big PP/academic groups or supply large metro areas. Not that any programs will contract further, but it's more complicated than just saying to get rid of the small programs.

@seper
Bates, J. E., Parekh, A., Goodman, C. R., Chowdhary, M., Culbert, M. M., Royce, T. J., & Amdur, R. J. (2021). The Geography of Employment Outcomes for Radiation Oncology Graduates in 2019. International journal of radiation oncology, biology, physics, 109(4), 1119–1123.

"Graduates of smaller programs (≤6 residents) and those in smaller metropolitan areas were more likely to take positions in smaller metropolitan areas or nonmetropolitan areas."

 

[seper]

There is evidence that smaller programs are more likely to supply the areas of maldistribution than the bigger ones. Big name programs in big name cities are more likely to send to big PP/academic groups or supply large metro areas. Not that any programs will contract further, but it's more complicated than just saying to get rid of the small programs.

But what is the actual evidence?

 

[temujim]

Not coming at you personally, but this kind of mentality is part of the easy out that keeps serious discussions from ever happening. Chairs at the large programs can pay lip service to the idea that we would cut spots but suggest it shouldn’t be them because they have the resources and leaders to properly train the next generation. Smaller centers argue the big places should cut to maintain thought diversity and not train 80% of our trainees at 5 programs. It doesn’t matter…the only cuts that could ever happen are forced cuts from above. Even if a chair sincerely wanted to reduce their compliment, their Dean will argue it’s a bad look for the SOM and probably wouldn’t approve it.

In my crazy mind, the simplest formula is that the only possible numbers are 4, 8, or 12. Have to have at least 2.5-3x as many full time clinical faculty on main campus. Minimum of 10 clinical faculty to have a small program. No more of this adding 1-2 spots “because we can” BS or deciding that because you have 60 faculty, you should amass a small army of residents.

Sure it's a bit glib, but only a start. The reality is the only way to close a program is to raise "standards" at the ACGME. It would be good to make a case of what changes are necessary to make a "good" training program. I would argue that a minimum of 2 residents a year is part of that. Beyond that, a 2:1 MD faculty:resident ratio (at the main training site), a 1:1 physics faculty:resident ratio would slash a good number of slots. Pair this with deletion of pediatrics requirement and raising sealed/unsealed source requirement.

Would urge this board to keep an eye out for the next ACGME review cycle. Public comment is elicited. One of the few ways regular joes can have their voice heard. The last review did tighten up requirements, but nowhere near enough.