I think you are mostly right about most programs, but I have to say, from meeting people around, certain highly ranked places teach their residents the literature - they are definitely brainiacs and some of the smartest people I've met. But, they weren't necessarily instructed about the practicalities of modern image-based 3D/IMRT treatment planning - i.e. - contouring axial anatomy, simulation/set-up, etc. I was surprised when studying for board exams that many people were not well trained regarding "how-to" in terms of contouring pelvic LNs, contouring for gastric CA, etc. etc. or not know concepts of GTV-CTV-PTV planning vs bony anatomy/block margins. I've heard multiple times for head and neck "I'd contour level II, III, and IV lymph nodes and the supraclav" not realizing that level IV=supraclav. People talk about a 5cm longitudinal PTV margin for esophageal tumors to block margin when what they mean is a 2-3 cm for CTV, a cm for PTV, and then a block margin. Heck, even the older books don't explain it properly and some of the modern RTOG protocols don't get it clearly either - i.e. for GBM the volumes are huge compared to older texts!
I think what helps is if the program has a "generalist" or an instructor that knows the practicalities of "how to treat" that is able to show you those things, so when you get out there, you aren't doing things wrong.
It's easy enough to say - "I'd contour out the gross tumor, paraesophageal lymph nodes, celiac LNs b/c it's distal" but hard to actually do it, unless you actually get taught. In the community, you see people who just don't know how to do some very basic things in terms of 3D/IMRT treatment planning.
