2022 Match Game

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thecarbonionangle said:
According to google doc, iowa is expanding. Can anyone confirm? That would be ridiculous!
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Per earlier in this thread, they matched someone from the Caribbean who had done a year at Anderson. Reading further into their profile, it was their third time attempting to match??
 
Assuming its true, it would just be ridiculous CCF cuts a spot and their own graduate PD at Iowa adds one. if this is not true then ignore it just curious
 
medgator said:
Per earlier in this thread, they matched someone from the Caribbean who had done a year at Anderson. Reading further into their profile, it was their third time attempting to match??
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not to disparage anyone out there, people change yada yada, but having met the carib grad that iowa matched some years back i personally would not have ranked them in a million years. that they were able to match in this environment is a truly damning indictment on the state of our field.
 
radOresident said:
not to disparage anyone out there, people change yada yada, but having met the carib grad that iowa matched some years back i personally would not have ranked them in a million years. that they were able to match in this environment is a truly damning indictment on the state of our field.
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The fact that anyone took a year off to try and match into rad onc within the last few years is shocking to me, the fact that they could only muster Iowa after all, even more so
 
medgator said:
The fact that anyone took a year off to try and match into rad onc within the last few years is shocking to me, the fact that they could only muster Iowa after all, even more so
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i wouldnt focus so much on individuals applying. I don’t know them outside of ones I reviewed and interviewed. They are now matched so i wish them luck. I dislike the current state of the field and the “leaders” continuing to pretend all is fine and filling their programs with warm bodies. This widespread lack of leadership is our true problem. I don’t see a way to fix it. If programs will continue to fill there is no market correction. Canaries are long dead.
 
thecarbonionangle said:
i wouldnt focus so much on individuals applying. I don’t know them outside of ones I reviewed and interviewed. They are now matched so i wish them luck. I dislike the current state of the field and the “leaders” continuing to pretend all is fine and filling their programs with warm bodies. This widespread lack of leadership is our true problem. I don’t see a way to fix it. If programs will continue to fill there is no market correction. Canaries are long dead.
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I agree. It’s rad onc it’s not that hard. As long as people aren’t personality problems, they’ll be fine. Now if some of these folks are major headaches to deal with and are bad culture fits - then that’s on the program!

If you eat soap, you’ll be totally fine most of the time. May not taste good, but you won’t die. But it may cause you some major GI upset every once in a while
 
The list of places at unfilled programs from the spreadsheet (28) seems to be 5 or 6 spots short of the official NRMP regional report's count of unfilled spots (~33, not counting reserved/physician match). Anyone know which other places didn't fill?
 
zapzapzap said:
The list of places at unfilled programs from the spreadsheet (28) seems to be 5 or 6 spots short of the official NRMP regional report's count of unfilled spots (~33, not counting reserved/physician match). Anyone know which other places didn't fill?
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I would love to know this too. These are the sneakiest of places who quietly fill outside the match, closed doors, nothing to see. Can’t shed light on it unless someone outs them
 
thecarbonionangle said:
According to google doc, iowa is expanding. Can anyone confirm? That would be ridiculous!
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I can confirm this is not true. Talked to their PD. They have had 7 spots for years. They used to be on a 2-2-2-1 match cycle but because of a transfer a while back they are on a 2-2-3-0 cycle. No expansion.
 
Word on the street is people matched this year who failed boards multiple times and took a year off before residency.... People getting step 1 scores under 200 etc. Wouldn't be surprised to see some folks that failed a year of med school either. Can't get more specific than that but I'm sure someone else here can corroborate the type of people our specialty is matching these days
 
medgator said:
Word on the street is people matched this year who failed boards multiple times and took a year off before residency.... People getting step 1 scores under 200 etc. Wouldn't be surprised to see some folks that failed a year of med school either. Can't get more specific than that but I'm sure someone else here can corroborate the type of people our specialty is matching these days
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They are out there but it isn't as bad as that. Most of the applicants are low-mid tier US grads who are not horrible, just wouldn't have even sniffed out an interview when we were matching a decade or two ago. A lot of the boards failures I saw in my stack came from FMGs and I honestly have a bit of trouble knowing what to make of that. US med schools typically tailor testing and education to USMLE written exams and I am willing to give FMGs a little more leeway in that I am more willing to interview them to see if I think the problem is that they are an FMG or clinically weak. Repeat failures is always a red flag but if an FMG failed once, then did pretty well on a second try and interviews well, I don't look at it as a huge red flag.

I can't say it is universally true, but most of the repeat failures I encountered were from...Caribbean grads. I'm personally not forgiving there at all. Those students 100% intended to take USMLE exams from the beginning and had all of the tools needed to pass. They just didn't. For the same reason they didn't get into a US med school.
 
ramsesthenice said:
Most of the applicants are low-mid tier US grads who are not horrible,
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This is fine. You don't have to be more than this to be a good doc in any field.
ramsesthenice said:
A lot of the boards failures I saw in my stack came from FMGs and I honestly have a bit of trouble knowing what to make of that
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This would be a red flag for me. In most fields (even outside of medicine) foreign applicants typically have stellar scores. It is part of the process for being considered for US training or graduate degree programs and there is often massive time commitment to these tests relative to US students. (I'm all in favor of pass/fail for boards btw as they are gamed with intense preparation. Best tests are the ones you don't directly study for.)
 
Back again, large city mid tier program in the Midwest

Yes: 60% of our applicants had step scores below 200; about 30% with multiple multiple failures

We aren’t soaping because we ranked EVERYBODY (we ranked that criminal dude last year too, didn’t match him though)
 
Baws said:
Back again, large city mid tier program in the Midwest

Yes: 60% of our applicants had step scores below 200; about 30% with multiple multiple failures

We aren’t soaping because we ranked EVERYBODY (we ranked that criminal dude last year too, didn’t match him though)
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Somewhat the same, but in NE. We didn't rank everyone though, about 75% of people interviewed? PD was fully prepared to SOAP though, blocked off his entire clinic schedule for this week.
 
ramsesthenice said:
I can confirm this is not true. Talked to their PD. They have had 7 spots for years. They used to be on a 2-2-2-1 match cycle but because of a transfer a while back they are on a 2-2-3-0 cycle. No expansion.
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Also wasn't a transfer, but a rather sad case. I was surprised she told me why during the interview trail.
 
ramsesthenice said:
I can confirm this is not true. Talked to their PD. They have had 7 spots for years. They used to be on a 2-2-2-1 match cycle but because of a transfer a while back they are on a 2-2-3-0 cycle. No expansion.
Click to expand...

There is a whole thread that list all the spots for every program year over year. No programs expanded their ACGME approved spots year over year. 2021 to 2022. Doesn't mean it can't happen moving forward though.
 
brushbeamscanning said:
Also wasn't a transfer, but a rather sad case. I was surprised she told me why during the interview trail.
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Was trying to leave that part out but yes, it was technically a celestial transfer 🙁

Baws said:
We aren’t soaping because we ranked EVERYBODY (we ranked that criminal dude last year too, didn’t match him though)
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I am not a fan. I think there are 2 separate considerations. Minimum qualifications vs matching the most qualified applicants from the pool. In my mind, the only thing that should have changed from years past is the latter. We are also a midwest program and I think we did a pretty good job. We ranked a couple people that I wouldn't personally have ranked, but overall we did pretty good. We got something like 60 applications, interviewed half, and then only ranked around 80% of the ones we interviewed. Definitely didn't go all in with the "match at all costs" mindset.
 
Baws said:
Back again, large city mid tier program in the Midwest

Yes: 60% of our applicants had step scores below 200; about 30% with multiple multiple failures

We aren’t soaping because we ranked EVERYBODY (we ranked that criminal dude last year too, didn’t match him though)
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That's ****ing terrible
 
Question about my match scenario: I have matched but of course won't find out until friday where. I have learned that my #1 ranked program still has 1 spot available for SOAP. Does this mean that I can be confident that residency program will be the name in the envelope I will open on friday???
 
CurbYourExpectations said:
Can we talk about how exploitative it is to take people into RadOnc that have no idea about the field when there is a giant concern for oversupply when they are at their lowest point after not matching to their specialty of choice?
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Exploitative would require the programs to care. The only thing seem to care about is warm bodies. It is obvious based on resident rosters which programs are taking people outside of the matched based on the two requirements of (1) Can you get a training license and (2) Are you alive? Shame on them, especially after we sat in committees and watched them pick exceptionally qualified candidates apart and not rank them based on being nervous or clothing choice or other trivial things only a few years ago.

Exploitative is the contract I just saw for a rural hospital position that locks the employee into a multiyear agreement and makes the employee pay back a year's worth of salary if there is a voluntary resignation, along with other things such as 10% decrease in salary every year, clause that says hospital keeps >50% of professional fees above a certain threshhold, annual income caps, etc. When you sign up for the Army at age 18, they make it clear that they own you and you can't leave. At least they are upfront and honest about it. I can't imagine taking that job and knowing you are trapped.

So maybe hiring these people is exploitative in that it is setting them up to exploited by a hospital in rural Iowa that's been running on locums for many years while trying to snag someone who needs a visa on the cheap?

I cannot get a practice in Florida to interview me. I have tried for years. Yet I am also told that concerns about there being no jobs are "bull---t". I came from a good medical school and passed all my exams and look fine on paper with zero red flags. My residency was in the Midwest though. What does the Caribbean grad think is going to happen training in Iowa with her C.V. when employers are already this picky? Will she get an interview at a private practice in Florida? Or will she be working in the tiny town above for 10% less every year for the rest of her career getting to enjoy the smell of the local feedlot when walking out of clinic every day?
 
futureMD2b18 said:
Question about my match scenario: I have matched but of course won't find out until friday where. I have learned that my #1 ranked program still has 1 spot available for SOAP. Does this mean that I can be confident that residency program will be the name in the envelope I will open on friday???
Click to expand...

99 percent yep! the only possibility is if for some reason they did not rank you. which seems unlikely

congrats!
 
futureMD2b18 said:
Question about my match scenario: I have matched but of course won't find out until friday where. I have learned that my #1 ranked program still has 1 spot available for SOAP. Does this mean that I can be confident that residency program will be the name in the envelope I will open on friday???
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I would think so. Unless they didn't rank you at all.

EDIT: should have kept scrolling.😛
 
Moonbeams said:
What does the Caribbean grad think is going to happen training in Iowa with her C.V. when employers are already this picky?
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I can tell you now that if that same Caribbean grad had gone through a medicine residency and completed any medonc fellowship without disciplinary action, they would be in mad demand at multiple coastal community oncology practices.

This is something the academics probably don't see. Recruiting for reasonable medical oncologists outside of major metro areas is desperate. The same locales have radoncs who trained at top places.
 
communitydoc13 said:
I can tell you now that if that same Caribbean grad had gone through a medicine residency and completed any medonc fellowship without disciplinary action, they would be in mad demand at multiple coastal community oncology practices.

This is something the academics probably don't see. Recruiting for reasonable medical oncologists outside of major metro areas is desperate. The same locales have radoncs who trained at top places.
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Or they have just done primary care. There is a decent chance they will end up stuck in feedlot land trying to jumpstart their truck in negative 40 degree windchill blowing cow farts in your face making less per day as a non BC locums that they would have as a PCP where they could have literally been done in 3 years, BC, and worked anywhere.
 
ramsesthenice said:
Was trying to leave that part out but yes, it was technically a celestial transfer 🙁


I am not a fan. I think there are 2 separate considerations. Minimum qualifications vs matching the most qualified applicants from the pool. In my mind, the only thing that should have changed from years past is the latter. We are also a midwest program and I think we did a pretty good job. We ranked a couple people that I wouldn't personally have ranked, but overall we did pretty good. We got something like 60 applications, interviewed half, and then only ranked around 80% of the ones we interviewed. Definitely didn't go all in with the "match at all costs" mindset.
Click to expand...
Are we not going to discuss this celestial transfer? How recent was this? Was it national news?
 
Moonbeams said:
Exploitative would require the programs to care. The only thing seem to care about is warm bodies. It is obvious based on resident rosters which programs are taking people outside of the matched based on the two requirements of (1) Can you get a training license and (2) Are you alive? Shame on them, especially after we sat in committees and watched them pick exceptionally qualified candidates apart and not rank them based on being nervous or clothing choice or other trivial things only a few years ago.

Exploitative is the contract I just saw for a rural hospital position that locks the employee into a multiyear agreement and makes the employee pay back a year's worth of salary if there is a voluntary resignation, along with other things such as 10% decrease in salary every year, clause that says hospital keeps >50% of professional fees above a certain threshhold, annual income caps, etc. When you sign up for the Army at age 18, they make it clear that they own you and you can't leave. At least they are upfront and honest about it. I can't imagine taking that job and knowing you are trapped.

So maybe hiring these people is exploitative in that it is setting them up to exploited by a hospital in rural Iowa that's been running on locums for many years while trying to snag someone who needs a visa on the cheap?

I cannot get a practice in Florida to interview me. I have tried for years. Yet I am also told that concerns about there being no jobs are "bull---t". I came from a good medical school and passed all my exams and look fine on paper with zero red flags. My residency was in the Midwest though. What does the Caribbean grad think is going to happen training in Iowa with her C.V. when employers are already this picky? Will she get an interview at a private practice in Florida? Or will she be working in the tiny town above for 10% less every year for the rest of her career getting to enjoy the smell of the local feedlot when walking out of clinic every day?
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Spencer, Iowa?
 
Baws said:
Are we not going to discuss this celestial transfer? How recent was this? Was it national news?
Click to expand...
I’m sure someone here knows more than I do. I don’t know the details but I think it was in the range of 8-10 years go. These thing are devastating. Along my training we had a resident in a different discipline commit suicide and it f@cked a lot of people up. Myself included. We were collaborating on a project at the time and I had no idea whatsoever they were struggling. I’m not going to speculate on this kind of situation without first hand knowledge.
 
I shadowed a radiation oncologist four or five years ago at a major academic center and he made it seem like everything was fine (plenty of volume, always busy). It seemed like interesting work. When does equilibrium shift back towards patient demand not being met by the current supply? Or is this demand never coming back due to immunotherapies and such?
 
voxveritatisetlucis said:
I shadowed a radiation oncologist four or five years ago at a major academic center and he made it seem like everything was fine (plenty of volume, always busy). It seemed like interesting work. When does equilibrium shift back towards patient demand not being met by the current supply? Or is this demand never coming back due to immunotherapies and such?
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Demand can not mathematically return. If all residencies shut down, we will still have 7000 radoncs in 2030s when the boomer bubble busts and medicine will be much better at select those pts who truly need radiation. Every year an indication for xrt falls by the wayside.
 
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Man the state of our field is depressing and I don't see a solution in sight. I've repeatedly implored the leadership of our residency program to cut down a spot. My pleas have fallen on deaf ears. They care more about attendings not having to do their own contours or put in their own orders. We are not going to have a correction in the market until those in leadership start to feel the impact in their salaries. that won't happen until the current junior people become decision makers. It's hard to convince a current chair/PD making 600K+ without having to write a single note that there is a problem in our field. Their salaries won't be cut, but the ceiling for those just entering the field will keep falling.
 
RADONC4285 said:
Man the state of our field is depressing and I don't see a solution in sight. I've repeatedly implored the leadership of our residency program to cut down a spot. My pleas have fallen on deaf ears. They care more about attendings not having to do their own contours or put in their own orders. We are not going to have a correction in the market until those in leadership start to feel the impact in their salaries. that won't happen until the current junior people become decision makers. It's hard to convince a current chair/PD making 600K+ without having to write a single note that there is a problem in our field. Their salaries won't be cut, but the ceiling for those just entering the field will keep falling.
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we have a huge problem in our field which is amplified by how small we are of people sitting at the top and blocking any sort of change. I had a convo with someone today and went somewhere like this:

Do you think so and so is retiring, they are getting close to medicare retirement age?
No they are never retiring. You will be called to do a sternal rub on them and declare them in a few decades in their fat office.

these boomers need to GTFO of the way and stop taking air completely out of room for others. Their voices are the loudest in any room. The problem is they never will and the field will not be able to rectify anything until nothing can be done. The situation is not going to change. We will be back at this again next year. Same hellpits, same usual subjects. deja vu while we all take it from behind.
 
thecarbonionangle said:
we have a huge problem in our field which is amplified by how small we are of people sitting at the top and blocking any sort of change. I had a convo with someone today and went somewhere like this:

Do you think so and so is retiring, they are getting close to medicare retirement age?
No they are never retiring. You will be called to do a sternal rub on them and declare them in a few decades in their fat office.

these boomers need to GTFO of the way and stop taking air completely out of room for others. Their voices are the loudest in any room. The problem is they never will and the field will not be able to rectify anything until nothing can be done. The situation is not going to change. We will be back at this again next year. Same hellpits, same usual subjects. deja vu while we all take it from behind.
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We have an attending who's almost 70 who refuses to retire. I wouldn't trust him to treat even a bone met without a good resident working with him, but our chair turns a blind eye. He makes almost 700K. Why would he voluntarily retire?
 
RADONC4285 said:
We have an attending who's almost 70 who refuses to retire. I wouldn't trust him to treat even a bone met without a good resident working with him, but our chair turns a blind eye. He makes almost 700K. Why would he voluntarily retire?
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Had an attending when I was a resident decades ago who was the same way. Actually went to the chair because this individual was dangerous. Just checked the department's website -- still there and truckin.
 
brushbeamscanning said:
Something I've always wondered is if some of these chairs can even contour and evaluate modern radiation plans? Most of them have a very light clinical service (in any) and are always faculty/resident supported. I would venture to say the minority of chairs would be able to function independently in clinic.
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Yeah many of them shouldn't be seeing patients. I don't have an issue with that as they are mostly administrative. But I have a huge issue with clinical attendings who trained in the 2d era still practicing and refusing to retire. That can be dangerous. We have a couple of attendings that we specifically assign senior residents to because we don't trust them to be safe. I know some have kept up and picked up 3d planning along the way, but some haven't
 
RADONC4285 said:
Yeah many of them shouldn't be seeing patients. I don't have an issue with that as they are mostly administrative. But I have a huge issue with clinical attendings who trained in the 2d era still practicing and refusing to retire. That can be dangerous. We have a couple of attendings that we specifically assign senior residents to because we don't trust them to be safe. I know some have kept up and picked up 3d planning along the way, but some haven't
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It’s interesting how common this is in radiation oncology and it seems to be part of the culture of the speciality. From what I’ve seen in surgery, they have no problem telling someone to retire once they are perceived to be no longer safe to operate.
 
RADONC4285 said:
We have an attending who's almost 70 who refuses to retire. I wouldn't trust him to treat even a bone met without a good resident working with him, but our chair turns a blind eye. He makes almost 700K. Why would he voluntarily retire?
Click to expand...
temujim said:
Had an attending when I was a resident decades ago who was the same way. Actually went to the chair because this individual was dangerous. Just checked the department's website -- still there and truckin.
Click to expand...
brushbeamscanning said:
Something I've always wondered is if some of these chairs can even contour and evaluate modern radiation plans? Most of them have a very light clinical service (in any) and are always faculty/resident supported. I would venture to say the minority of chairs would be able to function independently in clinic.
Click to expand...
RADONC4285 said:
Yeah many of them shouldn't be seeing patients. I don't have an issue with that as they are mostly administrative. But I have a huge issue with clinical attendings who trained in the 2d era still practicing and refusing to retire. That can be dangerous. We have a couple of attendings that we specifically assign senior residents to because we don't trust them to be safe. I know some have kept up and picked up 3d planning along the way, but some haven't
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I'm fairly certain we don't know each other in real life -

I can say the same thing, that I know multiple attendings both in academia and private practice that I also wouldn't trust with a bone met.

Nothing we can do about it, I guess.

(well, in my current role - I can edit cases between treatment planning and VSIM, but not everyone has that luxury)
 
voxveritatisetlucis said:
I shadowed a radiation oncologist four or five years ago at a major academic center and he made it seem like everything was fine (plenty of volume, always busy). It seemed like interesting work. When does equilibrium shift back towards patient demand not being met by the current supply? Or is this demand never coming back due to immunotherapies and such?
Click to expand...
Patient loads are not normally distributed in rad onc. There is a small fraction of very busy docs and a very large contingent of the not so busy. The very busy docs (tend to) cluster in large academic places. Yet even there, the high patient loads cluster to only a few docs! And even amongst the busiest of the busy, the patient loads are slowly creeping downward over time.
 
fiji128 said:
It’s interesting how common this is in radiation oncology and it seems to be part of the culture of the speciality. From what I’ve seen in surgery, they have no problem telling someone to retire once they are perceived to be no longer safe to operate.
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I suppose with surgery incompetece is much more difficult to hide. In radiation it's easy to just give these dinasaurs a resident to do their job. Even worse, with RT, the impact of our mistakes is often delayed and not easily linked to RT. The poor patient doesn't know their cancer recurred because the doctor didn't contour the tumor properly. We should have known. If our leadership has no issues overlooking serious patient safety issues, they sure as heck have no problem with trainees suffering for jobs. The messed up thing is most of these incompetent attendings have way more money than they need to retire. The two incompetent attendings in my program are worth in the 10s of millions. One of them has multiple vacation homes. The other's 1 million plus worth of Apple shares only make up a "small portion of my portfolio".
 
RADONC4285 said:
I suppose with surgery incompetece is much more difficult to hide. In radiation it's easy to just give these dinasaurs a resident to do their job. Even worse, with RT, the impact of our mistakes is often delayed and not easily linked to RT. The poor patient doesn't know their cancer recurred because the doctor didn't contour the tumor properly. We should have known. If our leadership has no issues overlooking serious patient safety issues, they sure as heck have no problem with trainees suffering for jobs. The messed up thing is most of these incompetent attendings have way more money than they need to retire. The two incompetent attendings in my program are worth in the 10s of millions. One of them has multiple vacation homes. The other's 1 million plus worth of Apple shares only make up a "small portion of my portfolio".
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Boomers gonna boom.

I mean look at Jay friggin Loeffler coming down to Naples after being chair at MGH to take his "retirement" PP gig. Guess that's another "job" that isn't going to someone up and coming, then again southwest FL hasn't exactly been the easiest place to find a job since it essentially has been run by boomers from the getgo

Many of these people will literally have to be carried out of their offices
 
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medgator said:
Boomers gonna boom.

I mean look at Jay friggin Loeffler coming down to Naples after being chair at MGH to take his "retirement" PP gig. Guess that's another "job" that isn't going to someone up and coming, then again southwest FL hasn't exactly been the easiest place to find a job since it essentially has been run by boomers from the getgo

Many of these people will literally have to be carried out of their offices
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Is Loeffler the same guy who would practically cut all ties with any MGH resident who took a PP job? Or was that some other Harvard snob?
 
RADONC4285 said:
Is Loeffler the same guy who would practically cut all ties with any MGH resident who took a PP job? Or was that some other Harvard snob?
Click to expand...
There are about 3 to 3.5 times as many (200 to 250% more) academic rad oncs today as 25 years ago but only about 1.25 times as many (25% more) PP rad oncs. So prior to about 25 years ago, the large majority of graduating residents headed to PP. it was around 2000-5 when this rapidly flipped. If you were PP and graduated prior to 2000 Jay, and most academic people, liked the PP guys. Then things got elitist.
 
When I was in my first week of residency, I was rotating with a breast attending who had seen/contoured an oropharyngeal (tonsil) patient on his own for whatever reason during the change over between classes. I was asked to review the finished plan by dosimetry. I didn't know much about H&N radiation at the time, but I did know you probably should treat the neck. And you should also treat the correct tonsil.

Saved a HUGE med mal case on like my 3rd day of residency.
 
RADONC4285 said:
Man the state of our field is depressing and I don't see a solution in sight. I've repeatedly implored the leadership of our residency program to cut down a spot. My pleas have fallen on deaf ears. They care more about attendings not having to do their own contours or put in their own orders. We are not going to have a correction in the market until those in leadership start to feel the impact in their salaries. that won't happen until the current junior people become decision makers. It's hard to convince a current chair/PD making 600K+ without having to write a single note that there is a problem in our field. Their salaries won't be cut, but the ceiling for those just entering the field will keep falling.
Click to expand...

I have done the same with pleading with leadership to cut down our spots. Instead, leadership is celebrating this week because we matched our full complement this year, after interviewing 75% of the applicants, just to avoid being on the unmatched/SOAP list.
 
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