What to look for in residencies?

[G'ville Nole]

I'm currently in the process of sifting through the information available on the web on all of the radiation oncology programs, trying to edit the list down to a suitable number of programs to which I will apply.

I am intending to apply to most of the programs that are regarded as "top tier". My difficulty lies in trying to distinguish the "middle tier" programs from one another. Half of my applications are likely to go to these programs, and I'd like to make a rational decision (apart from the ever-present geographical considerations) as to which programs I should include.

For those of you who have been through the process, what things should I be looking for? Specifically:

1) What sort of patient volume is considered adequate?
2) Is there a minimum "acceptable" level of technology I should look for? (e.g. no IMRT, no application?)

I guess these are really the two areas where I could use some advice. I have my own priorities w/r to research, benefits, etc., and I would consider those parameters to be "tie-breakers". I'd just like to be sure that I have a fair assessment of the "nuts and bolts" of these programs before applying these lesser criteria to them.

Thanks!

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[stephew]

Before anyting else, I should warn you not to be too prigish about where you apply to. Ive just seen a bunch of hopkins med students who had excellent scores and letters of reccommendation rank rather far down their list. So just a word of warning.


The ACGME has regulations as to "minimum" and "maxium" patient volume; being on either end isn't a good thing. Rad onc is so reading dense (I suspect among the most of all residency programs) that a busy clinic takes you to a point where you are missing out on reading you need to do. 250 pts per year isnt bad.

In terms of "acceptable" technology, you have to pick and choose. Proton beam? Who cares. Its neat but only two places have it and so you likely wont be using it late in life. IMRT. Yes you should get experience with that. IMRT at the expense of no Peds? Well that's up to you; which would you rather do as an outside rotation. both? The best. Gamma knife? Again only if you are looking to do it later.
Tomotherapy and cyberknife? Very cool toys but unclear how widespread these will be in the future. You definitely want 3D planning and CT-based sims. But you need to learn conventional stuff too, so a blend is best.
Good luck.