1st day as a RadOnc Resident --> Last day as a RadOnc Resident

Gfunk6

And to think . . . I hesitated
Moderator Emeritus
Lifetime Donor
Verified Expert
15+ Year Member
Apr 16, 2004
4,168
2,933
SF Bay Area
  1. Attending Physician
    So . . . how did it go for the rest of you guys?

    For me, it was exhilarating to finally start on my chosen career path after a painful q4-filled intern year. At the same time, it was simply overwhelming. After being indoctrinated in Medicine for a year, it was not easy to be tossed back into the wonderful world of RadOnc.

    But most of all, relief. All oncology patients, no more overnight call, evidence-focused medicine . . . can't wait to start!:)
     
    Last edited:

    radonc2011

    New Member
    10+ Year Member
    Mar 17, 2006
    7
    0
    1. Medical Student
      Totally agree. It feels great but VERY overwhelming in the sense that I feel like I knew way more rad onc as a 4th year med student than I do now. Time to start reading!!! Best of luck to all of us who survived PGY-1.
       
      About the Ads

      eidolon

      Member
      10+ Year Member
      5+ Year Member
      Oct 7, 2005
      55
      0
        First day as rad onc resident:

        1. feeling totally lost . . . wondering if the program made a mistake
        2. glad that internship is over yet sad at the same time
        3. attempting to read the first chapter of khan only to wonder if anyone could read that thing from cover to cover
         
        D

        deleted4401

          Don't let Khan get you down, man. Buy the other book by Stinson (Stenson?). Much easier, written for therapists but most of the stuff will get you through your course. RAPHEX questions once you learn the stuff.

          All the rest, it will take you a year to get comfortable. But, as everyone told me, it really will take a long time. I'm nearly a year in, and I finally see that I've learned something (i.e. explaining basic concepts to rotating students).

          -S
           

          stephew

          SDN Super Moderator
          Moderator Emeritus
          15+ Year Member
          Jun 7, 2001
          2,362
          7
          Boston
          travel.to
            khan may 'suck' but it is the gold standard in radiation oncology physics and is a necessity in learning physics.

            trust me its not a necessity. I scotched it as soon as i realized this and many i know have. What is true is that its the "gold standard" as a source for testing material so you need to know the concepts from that book. however you do NOT need that book to learn those concepts which is a good think but that is a challege with its turgid prose and its assumption that you have physics training and are just studying radonc physics. (note: khans' tx planning book is quite excellent).

            Frankly between a decent physics lecture and a good book, with occasional filler from khan for topics underreprested elshewere (such as brachy) is the best thing. With raphex practice.

            BTW Johns and Cunningham was the last "gold standard" and that one seemed to assume you were using it to GET your physics degree.
             

            Pewl

            The Dude Abides
            15+ Year Member
            Aug 8, 2005
            1,499
            5
            Hollywood Star Lanes
            1. Attending Physician
              trust me its not a necessity. I scotched it as soon as i realized this and many i know have. What is true is that its the "gold standard" as a source for testing material so you need to know the concepts from that book. however you do NOT need that book to learn those concepts which is a good think but that is a challege with its turgid prose and its assumption that you have physics training and are just studying radonc physics. (note: khans' tx planning book is quite excellent).

              Frankly between a decent physics lecture and a good book, with occasional filler from khan for topics underreprested elshewere (such as brachy) is the best thing. With raphex practice.

              BTW Johns and Cunningham was the last "gold standard" and that one seemed to assume you were using it to GET your physics degree.

              I remember using Johns and Cunningham as well as ATTIX in grad school. I definitely agree that these two books are meant for us physicists. Attix was quite possibly the most unpleasant textbook I'd ever come across.
               

              Gfunk6

              And to think . . . I hesitated
              Moderator Emeritus
              Lifetime Donor
              Verified Expert
              15+ Year Member
              Apr 16, 2004
              4,168
              2,933
              SF Bay Area
              1. Attending Physician
                2 weeks into RadOnc residency . . .

                The verdict? Awesome, simply awesome.

                All those sleepless nights as an intern when I was admitting my 10th homeless man w/ CAD/DM/PVD/CKD/HTN I dreamed of this day. And boy it has not disappointed.

                I feel privileged in the extreme to work with oncology patients all the time and help them at a difficult period in their life. The technology is great, just as expected. As a neophyte I'm still excited to draw volumes, write prescription doses, and read papers.

                For all of you toiling to get into this field, let me assure you that it is worth it! And to have off on weekends and holidays is just icing on the cake. I have so much free time compared to my intern year that I barely know what to do. But somehow I manage . . . ;)
                 

                QuantumMechanic

                Avatar=One of the Greats
                10+ Year Member
                5+ Year Member
                Nov 23, 2005
                2,455
                4
                Hilbert Space
                1. Medical Student
                  As a neophyte I'm still excited to draw volumes, write prescription doses, and read papers.

                  For all of you toiling to get into this field, let me assure you that it is worth it! And to have off on weekends and holidays is just icing on the cake. I have so much free time compared to my intern year that I barely know what to do. But somehow I manage . . . ;)

                  how much reading are you doing at home?
                   

                  Gfunk6

                  And to think . . . I hesitated
                  Moderator Emeritus
                  Lifetime Donor
                  Verified Expert
                  15+ Year Member
                  Apr 16, 2004
                  4,168
                  2,933
                  SF Bay Area
                  1. Attending Physician
                    Typically less than an hour per day, more on the weekends. I do quite a bit of reading b/w pts at work. My upper levels recommended that I focus on staging, classification, and treatment categories. With this as a framework, it will be easier to memorize which studies support which recommendations.
                     
                    About the Ads

                    3dtp

                    Senior Member
                    10+ Year Member
                    Nov 27, 2005
                    663
                    12
                    midcoast
                    1. Attending Physician
                      I remember using Johns and Cunningham as well as ATTIX in grad school. I definitely agree that these two books are meant for us physicists. Attix was quite possibly the most unpleasant textbook I'd ever come across.

                      Really? I loved Attix. I had a discussion with one of our physicists recently. We came to the conclusion as I noted that his Attix was more ragged than mine, the only real way to hire a good physicist is to have him bring his copy of Attix to the interview. Well worn=hire! :)
                       

                      Gfunk6

                      And to think . . . I hesitated
                      Moderator Emeritus
                      Lifetime Donor
                      Verified Expert
                      15+ Year Member
                      Apr 16, 2004
                      4,168
                      2,933
                      SF Bay Area
                      1. Attending Physician
                        Hard to believe I started this thread four years ago. I'm not quite finished as a resident, but I'm done as far as clinical training is concerned. This last month will be spent tying up some research projects and studying for boards.

                        It's been a great ride. I couldn't be happier that I chose this speciality and the end result (job) couldn't have worked out better for me. Of course I've the usual apprehensions about finally practicing independently but I think my training has prepared me for it. Also my co-attendings know their stuff and can help when needed.

                        Best of luck to all my fellow PGY-5's about to embark on their careers!
                         

                        thesauce

                        Senior Member
                        15+ Year Member
                        Aug 5, 2005
                        3,259
                        407
                        1. Attending Physician
                          Hard to believe I started this thread four years ago. I'm not quite finished as a resident, but I'm done as far as clinical training is concerned. This last month will be spent tying up some research projects and studying for boards.

                          It's been a great ride. I couldn't be happier that I chose this speciality and the end result (job) couldn't have worked out better for me. Of course I've the usual apprehensions about finally practicing independently but I think my training has prepared me for it. Also my co-attendings know their stuff and can help when needed.

                          Best of luck to all my fellow PGY-5's about to embark on their careers!

                          How about the incoming PGY-2ers about to be where you were in 2007?

                          I feel the same way you did - overwhelmed but very excited. I still have a pretty tough intern month to go and a 2k+ mile drive ahead of me, but I'm sure it'll go by fast. I absolutely love my radonc program but it'll be hard to go back to the bottom of the totem pole. It sure seems like we have to do that a lot.
                           

                          KarmaDoc

                          Full Member
                          Mar 13, 2011
                          18
                          0
                            Congratulations Gfunk! I must say, it's very cool to see your first post as a resident as well as your last. Did any of your expectations or conceptions about radonc change from your first day compared to now?
                             

                            Gfunk6

                            And to think . . . I hesitated
                            Moderator Emeritus
                            Lifetime Donor
                            Verified Expert
                            15+ Year Member
                            Apr 16, 2004
                            4,168
                            2,933
                            SF Bay Area
                            1. Attending Physician
                              Here are some random, stream-of-consciousness observations. Take 'em or leave 'em.

                              1. The fund of knowledge in Rad Onc is VAST. Seriously. Ridiculously over-the-top. Of course, this is something I had an appreciation for even before I started. This is one reason that academics is appealing, you get a sub-site or two and became a super-expert. Once I graduate, it is inevitable that less used areas of clinical knowledge will begin to deteriorate. The price you pay to maintain them is CME.

                              2. I learned more about the economics of Rad Onc during my interviews and with my new practice than during my entire residency. It's complex and forever a moving target. I think earning a straight salary, in some ways, frees you from some of the ethical murkiness that goes on with reimbursement. However, when you collect revenue (especially technical fees) you feel that nobody else is financially benefiting from your own hard work.

                              3. Rad Onc program rankings are flawed, in part, because of regional preference. Applicants who train in one area of the country x 4 years are likely to put down some roots, begin raising a family, and easily obtain local job prospects. Thus, it does not make sense to judge graduating residents in the Midwest on their ability to gain jobs on the coasts - they likely neither wanted nor tried to go there. Exceptions exist of course, but this is a general trend I've noticed.

                              4. If you want an academic job, you really should have a minimum of four publications (one for each year). If you go for quality rather than quantity, this may hurt you because it seems that most people are interested in numbers. I think, at most places, one paper in Nature won't go as far as four papers in the Red Journal, for instance. Physician-scientist jobs are a bit of an exception.

                              5. Print is dead. I know all of us like to tote around Rad Onc textbooks, handbooks, and guides because it "feels" good and there's nothing like the tactile feedback from turning pages. However, at the end of four years you will be stuck with out-of-date paperweights. Use PDFs and start backing up your data regularly. There are, of course, some "classic" books that will never cease to be relevant.

                              6. Rad Onc is a small, "gossipy" field. If you are an a-hole, it will go around believe me. It surprises me at how many callous people I see who utterly lack insight into how they treat others. Karma's a bitch.

                              7. Always keep your eyes and ears open for opportunities. Many times you will be shut out of something you try desperately to attain while a "golden ticket" you weren't expecting falls into your lap. If you fixate on the unobtainable thing, you may miss the "golden ticket." Chance favors the prepared mind.

                              8. If you are married or have a SO +/- kids, the happiness of your family is paramount. Don't go somewhere for a "perfect" job opportunity when your family objects. It won't remain "perfect" for long.

                              9. Don't be a radoncanon. People in this field tend to be nice, well-adjusted types who are not prone to vindictive rampages based on witty internet postings. Also, connections are vital and you can potentially make MANY on this forum. I can't tell you how many dozens of forum members I know personally and I've met in real life. These are great folks and you can learn from them just as you can help others. Don't be a lurker, give back.
                               

                              mdphdgirl

                              Full Member
                              Oct 29, 2010
                              20
                              0
                              1. Resident [Any Field]
                                Thanks for updating this thread! It's great to see your reactions to the start of residency now that you are almost done! As a newly minted MD, it is always nice to see people actually make it through. (I know a bunch of people in my MD/PhD program who see me as proof you can complete both degrees, so I guess it's all a cycle of perspectives.)

                                dont spend your time reading radonc. learn your basic medicine. if you really want to do any reading just read up on radonc emergnecies like brain mets or cord compression.

                                I'm a little surprised at this comment. All the residents I met on interviews said that they didn't use much of their basic medicine once they started residency. So is it just that you should stick to studying medicine to get through the year, or is there really no reason to start learning rad onc until residency starts?
                                 

                                Gfunk6

                                And to think . . . I hesitated
                                Moderator Emeritus
                                Lifetime Donor
                                Verified Expert
                                15+ Year Member
                                Apr 16, 2004
                                4,168
                                2,933
                                SF Bay Area
                                1. Attending Physician
                                  I'm a little surprised at this comment. All the residents I met on interviews said that they didn't use much of their basic medicine once they started residency. So is it just that you should stick to studying medicine to get through the year, or is there really no reason to start learning rad onc until residency starts?

                                  The former. Stick to studying medicine b/c it will obviously be relevant to your intern year and also help you to study for Step 3. Studying Rad Onc when you are not practicing it clinically is worthless in my experience.
                                   

                                  napoleondynamite

                                  Keepin' it real yo
                                  10+ Year Member
                                  Nov 28, 2005
                                  844
                                  77
                                  1. Attending Physician
                                    Totally agree with Gfunk. Bloom in the rotation that you are in, rather than planting seeds in barren soil by opening up a radonc textbook while you are on your ICU rotation - you will retain less than 1% of what you are reading and (more importantly) will miss the one opportunity you have to learn medicine. It just doesn't make any sense and is low yield. I understand the temptation to want to start your career NOW, but you will have ample opportunity to read and study radonc for the rest of your life.

                                    The most impressive medical students or residents who rotate through our department are the ones who are not going into radonc, but notwithstanding, show up every day and are genuinely interested in learning about what we do. I think those type of people are the ones who also end up being the best doctors in their own specialty because they are just passionate about learning and medicine in general and I think that curiosity takes them a long way.
                                     
                                    About the Ads

                                    AZtoMD

                                    New Member
                                    Jun 5, 2011
                                    6
                                    0
                                    1. Resident [Any Field]
                                      Good stuff from the departing residents! I'm only a PGY2 (going on PGY3), and I feel like I know almost nothing. In fact, I'm confident that I may know almost nothing. It's good to know that it gets better. Good luck in your endeavours...
                                       

                                      Maforce

                                      Full Member
                                      7+ Year Member
                                      Jun 12, 2011
                                      35
                                      0
                                      1. Attending Physician
                                        Here are some random, stream-of-consciousness observations. Take 'em or leave 'em.

                                        1. The fund of knowledge in Rad Onc is VAST. Seriously. Ridiculously over-the-top. Of course, this is something I had an appreciation for even before I started. This is one reason that academics is appealing, you get a sub-site or two and became a super-expert. Once I graduate, it is inevitable that less used areas of clinical knowledge will begin to deteriorate. The price you pay to maintain them is CME.

                                        2. I learned more about the economics of Rad Onc during my interviews and with my new practice than during my entire residency. It's complex and forever a moving target. I think earning a straight salary, in some ways, frees you from some of the ethical murkiness that goes on with reimbursement. However, when you collect revenue (especially technical fees) you feel that nobody else is financially benefiting from your own hard work.

                                        3. Rad Onc program rankings are flawed, in part, because of regional preference. Applicants who train in one area of the country x 4 years are likely to put down some roots, begin raising a family, and easily obtain local job prospects. Thus, it does not make sense to judge graduating residents in the Midwest on their ability to gain jobs on the coasts - they likely neither wanted nor tried to go there. Exceptions exist of course, but this is a general trend I've noticed.

                                        4. If you want an academic job, you really should have a minimum of four publications (one for each year). If you go for quality rather than quantity, this may hurt you because it seems that most people are interested in numbers. I think, at most places, one paper in Nature won't go as far as four papers in the Red Journal, for instance. Physician-scientist jobs are a bit of an exception.

                                        5. Print is dead. I know all of us like to tote around Rad Onc textbooks, handbooks, and guides because it "feels" good and there's nothing like the tactile feedback from turning pages. However, at the end of four years you will be stuck with out-of-date paperweights. Use PDFs and start backing up your data regularly. There are, of course, some "classic" books that will never cease to be relevant.

                                        6. Rad Onc is a small, "gossipy" field. If you are an a-hole, it will go around believe me. It surprises me at how many callous people I see who utterly lack insight into how they treat others. Karma's a bitch.

                                        7. Always keep your eyes and ears open for opportunities. Many times you will be shut out of something you try desperately to attain while a "golden ticket" you weren't expecting falls into your lap. If you fixate on the unobtainable thing, you may miss the "golden ticket." Chance favors the prepared mind.

                                        8. If you are married or have a SO +/- kids, the happiness of your family is paramount. Don't go somewhere for a "perfect" job opportunity when your family objects. It won't remain "perfect" for long.

                                        9. Don't be a radoncanon. People in this field tend to be nice, well-adjusted types who are not prone to vindictive rampages based on witty internet postings. Also, connections are vital and you can potentially make MANY on this forum. I can't tell you how many dozens of forum members I know personally and I've met in real life. These are great folks and you can learn from them just as you can help others. Don't be a lurker, give back.


                                        Thank you for the pointers and the words of wisdom. Will be starting PGY2 in a few wks...excited and nervous. Congrats on being done!
                                         

                                        subatomicdoc

                                        Full Member
                                        10+ Year Member
                                        7+ Year Member
                                        Oct 15, 2007
                                        102
                                        19
                                        New England
                                        www.subatomicdoc.com
                                        1. Attending Physician
                                          Here are some random, stream-of-consciousness observations. Take 'em or leave 'em.

                                          6. Rad Onc is a small, "gossipy" field. If you are an a-hole, it will go around believe me. It surprises me at how many callous people I see who utterly lack insight into how they treat others. Karma's a bitch.

                                          This statement becomes more true with each passing year. Reputation and integrity go a long way, and both are much easier to lose than revive.
                                           

                                          RadOncDoc21

                                          Full Member
                                          10+ Year Member
                                          Oct 24, 2010
                                          2,247
                                          3,257
                                          1. Attending Physician
                                            Congrats to all my fellow PGY-5's, we are finally entering the real world. Also congrats to those of you who are starting Rad Onc tomorrow . . . you've finally reached the promised land!

                                            Congrats Gfunk6 and to all of those who just recently finished... I just started my first day of training and literally don't know where to begin. I'm just glad I have a long weekend to help get my bearings configured. There are just too many great resources out there but I am truly happy with my program and being around my fellow residents felt great.

                                            Where should I spend my book money?

                                            -R
                                             

                                            RadOncDoc21

                                            Full Member
                                            10+ Year Member
                                            Oct 24, 2010
                                            2,247
                                            3,257
                                            1. Attending Physician
                                              Congrats to all my fellow PGY-5's, we are finally entering the real world. Also congrats to those of you who are starting Rad Onc tomorrow . . . you've finally reached the promised land!

                                              Congrats Gfunk6 and to all of those who just recently finished... I just started my first day of training and literally don't know where to begin. I'm just glad I have a long weekend to help get my bearings configured. There are just too many great resources out there but I am truly happy with my program and being around my fellow residents felt great.

                                              Where and on what should I spend my book money?

                                              -R
                                               

                                              napoleondynamite

                                              Keepin' it real yo
                                              10+ Year Member
                                              Nov 28, 2005
                                              844
                                              77
                                              1. Attending Physician
                                                Congrats Funk and thanks for all of the advice over the years! Hard to believe that I am a PGY5 now :eek: But it's a good feeling to be one step closer to the dream job :D

                                                As for book $$ RadOncDoc, I would buy the (new version) of Hall for Radbio. Both the Haffty (purple) and Roach (blue) handbooks are worth buying. Personally, I wouldn't waste the $$ on Khan (pay for the shipping and I'll send you mine for free!). The green Stanton and Stinson is a good basic book for Physics. Also, I would not personally buy a textbook at this point - they are all out of date by the time they are printed and there are probably plenty floating around your department. There are so many free electronic resources these days, that I just don't think it's worth it anymore. Get yourself an NCCN account, register with ASTRO so you start getting the Red Journal, bookmark radoncwiki as a "favorite" and I think you're good to go for awhile.

                                                Best of luck to all the PGY2's and welcome!
                                                 

                                                Charles_Carmichael

                                                Full Member
                                                Moderator Emeritus
                                                10+ Year Member
                                                Verified Expert
                                                May 11, 2008
                                                4,078
                                                42
                                                1. Non-Student
                                                  Congrats Gfunk6 and to all of those who just recently finished... I just started my first day of training and literally don't know where to begin.

                                                  Congrats Funk and thanks for all of the advice over the years! Hard to believe that I am a PGY5 now :eek: But it's a good feeling to be one step closer to the dream job :D
                                                  +1

                                                  Congrats G and all the new attendings! :)
                                                   

                                                  RadOncDoc21

                                                  Full Member
                                                  10+ Year Member
                                                  Oct 24, 2010
                                                  2,247
                                                  3,257
                                                  1. Attending Physician
                                                    Thanks NapoleonD and others for all the helpful advice...very much appreciated.

                                                    -R
                                                    Congrats Funk and thanks for all of the advice over the years! Hard to believe that I am a PGY5 now :eek: But it's a good feeling to be one step closer to the dream job :D

                                                    As for book $$ RadOncDoc, I would buy the (new version) of Hall for Radbio. Both the Haffty (purple) and Roach (blue) handbooks are worth buying. Personally, I wouldn't waste the $$ on Khan (pay for the shipping and I'll send you mine for free!). The green Stanton and Stinson is a good basic book for Physics. Also, I would not personally buy a textbook at this point - they are all out of date by the time they are printed and there are probably plenty floating around your department. There are so many free electronic resources these days, that I just don't think it's worth it anymore. Get yourself an NCCN account, register with ASTRO so you start getting the Red Journal, bookmark radoncwiki as a "favorite" and I think you're good to go for awhile.

                                                    Best of luck to all the PGY2's and welcome!
                                                     
                                                    About the Ads
                                                    This thread is more than 10 years old.

                                                    Your message may be considered spam for the following reasons:

                                                    1. Your new thread title is very short, and likely is unhelpful.
                                                    2. Your reply is very short and likely does not add anything to the thread.
                                                    3. Your reply is very long and likely does not add anything to the thread.
                                                    4. It is very likely that it does not need any further discussion and thus bumping it serves no purpose.
                                                    5. Your message is mostly quotes or spoilers.
                                                    6. Your reply has occurred very quickly after a previous reply and likely does not add anything to the thread.
                                                    7. This thread is locked.