2022 Match Game

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There’s no shortage of rad onc doctors. If current Uber qualified graduating residents are saying: I’m having a hard time finding a job and a program says: Let’s fill our spots with FMGs to make it harder, I think you’re not doing the field any favors.
 
shill5604 said:
There’s no shortage of rad onc doctors. If current Uber qualified graduating residents are saying: I’m having a hard time finding a job and a program says: Let’s fill our spots with FMGs to make it harder, I think you’re not doing the field any favors.
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dont think anyones on the other side of this issue here!
 
Look at all the hellpits who SOAPED and congratulated themselves in so called “match parties”. Warm bodies is all that matters. The chairs can drink their don perignon with tortured baby cow, cooked rare and sleep well tonight. Maybe one day the widowmaker will do us all a favor. It is gonna take these people dying off so we can fix this. I see no solution in sight. Eat more steak, please.
 
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RadsWFA1900 said:
I think we already know the answer to this if you strip away the utter nonsense that gets wrapped in a typical RO residency.

What are you actually doing day to day. See consult sim contour manage on treatment and send off. Memorize target volumes, dose constraints and nccn guidelines. Throw in some statistics to memorize and presto. The rad bio rad physics nowadays is a joke at most places especially the biology portion as nobody is actually actively looking at it.

So back to the question, how qualified do you need to be to competently perform this specialty. On the spectrum of physician tasks that are performed day in and day out…we really aren’t special.

Like hypofrac, not hogging true scientific talent the way we have and allowing thr more qualified students to seek out other fields we are doing everyone else in medicine and society a favor.
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But far more difficult in daily practice than many other oncologic specialties. If anything we should play that up to dissuade more med students from entering the field.

Rad onc turning back the clock to the 70s-90s.
 
We can’t simultaneously complain that some of the older docs do IMRT poorly (docs that matched in the last era of minimal competitiveness), and then open the floodgates wide today to whomever with what passes for a medical degree

Once you’re in, you’re in for life
 
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yesmaster said:
We can’t simultaneously complain that some of the older docs do IMRT poorly (docs that matched in the last era of minimal competitiveness), and then open the floodgates wide to whomever or whoever with what passes for a medical degree
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so you think the reason that someone who trained in the 80s cant do IMRT has to do with them not being smart enough? and not because they trained in an older tech era and as we become older it becomes harder to learn new things, the same way that happens to any of us the longer we are in practice?


get real
 
jondunn said:
so you think the reason that someone who trained in the 80s cant do IMRT has to do with them not being smart enough? and not because they trained in an older tech era and as we become older it becomes harder to learn new things, the same way that happens to any of us the longer we are in practice?


get effing real, dude.
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Have you met some of the docs that graduated from the 70s-90s? Did you see the desirability (or lack thereof) of the field back then? China pen skills on a conventional simulator are nothing like the skill set needed for contouring, generating and evaluating an IMRT or SBRT plan.
 
medgator said:
China pen skills on a conventional simulator are nothing like the skill set needed for contouring, generating and evaluating an IMRT or SBRT plan.
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you're making my point for me.
 
medgator said:
How do older surgeons master the robot? Have you met some of the docs that graduated from the 70s-90s? China pen skills on a conventional simulator are nothing like the skill set needed for contouring, generating and evaluating an IMRT or SBRT plan
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True story. After residency i needed money so i did a locum in a middle of nowhere place. The guy who was there covering the other half was one of these guys. He asked me for help daily. He did not even feel comfortable approving a breast plan. I basically did most of the work so someone would not be killed.
 
'How do older surgeons master the robot?


the same way many older rad oncs have mastered modern rad onc.

the same way many older surgeons DON'T do robotic cases.
 
jondunn said:
'How do older surgeons master the robot?


the same way many older rad oncs have mastered modern rad onc.

the same way many older surgeons DON'T do robotic cases.
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Except some of them do, because surgical residencies are less apt to match warm bodies and have actual standards for case logs
 
i legit can't believe some of you are so high on your own supply that you think your extra 20 points on Step 1 improved your skills as a radiation oncologist.
 
medgator said:
How about the fact we didn't have to take it multiple times?
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sure if there is someone that has had multiple step 1 failures, they may struggle to do well on inservice, pass boards, maybe yes, it could indicate they are bad at tests.

but they would also struggle in IM. or path. or any field.
 
RadsWFA1900 said:
I think we already know the answer to this if you strip away the utter nonsense that gets wrapped in a typical RO residency.

What are you actually doing day to day. See consult sim contour manage on treatment and send off. Memorize target volumes, dose constraints and nccn guidelines. Throw in some statistics to memorize and presto. The rad bio rad physics nowadays is a joke at most places especially the biology portion as nobody is actually actively looking at it.

So back to the question, how qualified do you need to be to competently perform this specialty. On the spectrum of physician tasks that are performed day in and day out…we really aren’t special.
Click to expand...
This needs to be repeated, over and over.

RadOnc is not special. It is not any more or less difficult than any other specialty in medicine. However, we're not born knowing how to treat people with radiation. It's a skill that needs to be learned.

For 20 years now, RadOnc has been filled with people with excellent grades and tests scores. While those metrics don't predict who will or will not be a "good" physician (however that's defined), grades/scores generally predict who will be better able to teach themselves from books/papers with little guidance. Being able to "easily" memorize a textbook isn't inherently "good" or "bad". It's like how some people can sing or paint while others can't - it is what it is.

However, being able to memorize a textbook means you are more equipped to survive an environment where few are interested in actually teaching you. I did my intern year in a traditional Internal Medicine program. The difference in my experience there vs RadOnc was ASTOUNDING. I remember PulmCrit fellows had these 5 minute chalk talks they would give unprompted on rounds. Senior medicine residents would randomly have short teaching sessions in the team room. Attendings on service would come to the floors after their clinics to check in and do their own 5 minute chalk talks.

That almost never happened in my residency. Most of the time it was just me, my laptop, and eContour. Like the majority of people who Matched before the bubble burst, I have a natural ability to memorize books on my own. I made it work. It wasn't ideal, and it wasn't what I thought residency would be.

This is my concern for the incoming classes of FMG/IMG/people with lower board scores and grades. Do I think they can be great Radiation Oncologists? Yes, absolutely. But MOST PEOPLE require teaching and guidance to learn a profession, and the more complicated a profession is (like modern medicine), the more teaching and guidance is required.

I'm glad RadOnc crashed in competitiveness. It's the start of a wake up call after many years of resting on laurels. However, I think the pain is only beginning. I'm worried people who would otherwise be amazing Radiation Oncologists are going to struggle because residency programs haven't had much pressure to focus on the "education" side of the "service for education" equation that was supposed to be the agreement between institutions and trainees.

The next decade is going to be interesting.
 
jondunn said:
so you think the reason that someone who trained in the 80s cant do IMRT has to do with them not being smart enough? and not because they trained in an older tech era and as we become older it becomes harder to learn new things, the same way that happens to any of us the longer we are in practice?


get real
Click to expand...

My experience with some super competent 60-70+ year old rad oncs suggest that being “smart enough” or conscientious enough or humble enough to learn something new is, indeed, a factor.
 
elementaryschooleconomics said:
This needs to be repeated, over and over.

RadOnc is not special. It is not any more or less difficult than any other specialty in medicine. However, we're not born knowing how to treat people with radiation. It's a skill that needs to be learned.

For 20 years now, RadOnc has been filled with people with excellent grades and tests scores. While those metrics don't predict who will or will not be a "good" physician (however that's defined), grades/scores generally predict who will be better able to teach themselves from books/papers with little guidance. Being able to "easily" memorize a textbook isn't inherently "good" or "bad". It's like how some people can sing or paint while others can't - it is what it is.

However, being able to memorize a textbook means you are more equipped to survive an environment where few are interested in actually teaching you. I did my intern year in a traditional Internal Medicine program. The difference in my experience there vs RadOnc was ASTOUNDING. I remember PulmCrit fellows had these 5 minute chalk talks they would give unprompted on rounds. Senior medicine residents would randomly have short teaching sessions in the team room. Attendings on service would come to the floors after their clinics to check in and do their own 5 minute chalk talks.

That almost never happened in my residency. Most of the time it was just me, my laptop, and eContour. Like the majority of people who Matched before the bubble burst, I have a natural ability to memorize books on my own. I made it work. It wasn't ideal, and it wasn't what I thought residency would be.

This is my concern for the incoming classes of FMG/IMG/people with lower board scores and grades. Do I think they can be great Radiation Oncologists? Yes, absolutely. But MOST PEOPLE require teaching and guidance to learn a profession, and the more complicated a profession is (like modern medicine), the more teaching and guidance is required.

I'm glad RadOnc crashed in competitiveness. It's the start of a wake up call after many years of resting on laurels. However, I think the pain is only beginning. I'm worried people who would otherwise be amazing Radiation Oncologists are going to struggle because residency programs haven't had much pressure to focus on the "education" side of the "service for education" equation that was supposed to be the agreement between institutions and trainees.

The next decade is going to be interesting.
Click to expand...

By interesting it will probably get worse. There isnt anything redeeming about RO now. No new tech or drug. The bright ones were willing to drink the kool aid because they can have a chill attending life and make surg sub money for far less work. When that **** dried up and the dept chairs lost the little goodies to entice these pathologcal overachievers, the jig was up and they moved on to what was always an acceptable alternative the not so bright members of the medical establishment and FMGs that want to practice in the states.
 
yesmaster said:
My experience with some super competent 60-70+ year old rad oncs suggest that being “smart enough” or conscientious enough or humble enough to learn something new is, indeed, a factor.
Click to expand...

conscientious and humble are very different than 'smart' though.
 



I used to hear back in the day Yale was quite cush - is that still true?
 
elementaryschooleconomics said:
This needs to be repeated, over and over.

RadOnc is not special. It is not any more or less difficult than any other specialty in medicine. However, we're not born knowing how to treat people with radiation. It's a skill that needs to be learned.

For 20 years now, RadOnc has been filled with people with excellent grades and tests scores. While those metrics don't predict who will or will not be a "good" physician (however that's defined), grades/scores generally predict who will be better able to teach themselves from books/papers with little guidance. Being able to "easily" memorize a textbook isn't inherently "good" or "bad". It's like how some people can sing or paint while others can't - it is what it is.

However, being able to memorize a textbook means you are more equipped to survive an environment where few are interested in actually teaching you. I did my intern year in a traditional Internal Medicine program. The difference in my experience there vs RadOnc was ASTOUNDING. I remember PulmCrit fellows had these 5 minute chalk talks they would give unprompted on rounds. Senior medicine residents would randomly have short teaching sessions in the team room. Attendings on service would come to the floors after their clinics to check in and do their own 5 minute chalk talks.

That almost never happened in my residency. Most of the time it was just me, my laptop, and eContour. Like the majority of people who Matched before the bubble burst, I have a natural ability to memorize books on my own. I made it work. It wasn't ideal, and it wasn't what I thought residency would be.

This is my concern for the incoming classes of FMG/IMG/people with lower board scores and grades. Do I think they can be great Radiation Oncologists? Yes, absolutely. But MOST PEOPLE require teaching and guidance to learn a profession, and the more complicated a profession is (like modern medicine), the more teaching and guidance is required.

I'm glad RadOnc crashed in competitiveness. It's the start of a wake up call after many years of resting on laurels. However, I think the pain is only beginning. I'm worried people who would otherwise be amazing Radiation Oncologists are going to struggle because residency programs haven't had much pressure to focus on the "education" side of the "service for education" equation that was supposed to be the agreement between institutions and trainees.

The next decade is going to be interesting.
Click to expand...
Trained back in the day with people who got into rad onc in the 70s-90s during the transition to IMRT. Other than a few bright spots, residents trained each other/themselves.

Now that strong cohort of late 90s - mid 2010s is going to train the next generation of residents with declining scores/grades/english skills/etc. Folks who will struggle to understand inverse square law, selecting electron/photon/etc energies or other physics basics, identification of CT/MR based anatomy, or what have you (unfortunately all real examples). Real education institutions have already started pulling back on spots because they recognize the weak quality of many applicants. Hellpits gonna hellpit though.
 
Learning to contour, evaluate plans, real technical rad onc stuff is not that hard to learn how to do for most disease sites. Econtour, books, articles can teach you all of this and you can reference these when needed. What is a lot more difficult is being the only oncologist in the community and people relying on you from diagnosis to follow up for proper care. Where I work there are no oncologic trained surgeons. There's med onc, but they are unfortunately a little weaker outside of their field. They don't understand surgery well or anatomy, and they don't do physical exam like we do. Practicing oncology well isn't easy. There are a lot of different cancers, and you have to have some idea about how to treat all of them because the people around you don't understand cancer like we do. Our only hope to survive is to continue to be looked upon in our communities as oncologists. Its easy to be a technician, but its really hard to be a good doctor. That's what I'm afraid these weaker students will have trouble with.
 
jondunn said:



I used to hear back in the day Yale was quite cush - is that still true?
Click to expand...

Cush?... teaching faculty have 100% resident coverage year round and 100% cross coverage existed until only recently. In fact it still exists if a resident calls out sick or gives less than month's notice. So really only eliminated for pre-planned vacations. There is actually limited faculty teaching. A lot of junior faculty turnover recently. Several 2:1 attending:resident rotations, and 3-4:1 at one satellite.
 
Couple of fallouts from our staff meeting Friday:

-Nearby programs that are not SOAPing/failed to SOAP fully intend to fill their spots outside the match
-We are hiring 3 new faculty as soon as possible and then will freeze hiring for the immediate future, as the quality of radiation oncologists "is now clearly downtrending"
-Instructor positions will remain open (2-3 year contracts, ~$200,000 salary), and is likely how any vacancies will be filled

Current staff bonuses are increasing by 3-5% though
 
madchemist89 said:
Learning to contour, evaluate plans, real technical rad onc stuff is not that hard to learn how to do for most disease sites. Econtour, books, articles can teach you all of this and you can reference these when needed. What is a lot more difficult is being the only oncologist in the community and people relying on you from diagnosis to follow up for proper care. Where I work there are no oncologic trained surgeons. There's med onc, but they are unfortunately a little weaker outside of their field. They don't understand surgery well or anatomy, and they don't do physical exam like we do. Practicing oncology well isn't easy. There are a lot of different cancers, and you have to have some idea about how to treat all of them because the people around you don't understand cancer like we do. Our only hope to survive is to continue to be looked upon in our communities as oncologists. Its easy to be a technician, but its really hard to be a good doctor. That's what I'm afraid these weaker students will have trouble with.
Click to expand...
My guess is many new residents coming in will think these basic rad onc concepts are hard...

But otherwise absolutely agree with you. That's the old joke - surgeons know anatomy but don't know staging, and med oncs don't know either. As a rad onc you should know both anatomy and staging -- and know oncologic surgeries and systemic therapies and their underlying evidence, and of course everything about radiation oncology in order to be, and seen to be, a "complete" oncologist. And that is where these new lower tier candidates will really fail. And relegated to the back of the tumor board; not heard or respected.
 
temujim said:
My guess is many new residents coming in will think these basic rad onc concepts are hard...

But otherwise absolutely agree with you. That's the old joke - surgeons know anatomy but don't know staging, and med oncs don't know either. As a rad onc you should know both anatomy and staging -- and know oncologic surgeries and systemic therapies and their underlying evidence, and of course everything about radiation oncology in order to be, and seen to be, a "complete" oncologist. And that is where these new lower tier candidates will really fail. And relegated to the back of the tumor board; not heard or respected.
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Catfish in the basement like the good ol' days
 
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voxveritatisetlucis said:
i am a bit confused on why people from Mayo Clinic, Stanford, Yale etc. are trying to enter what many on here seem to call a “dying speciality.” Surely these people could have had their picks?
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if you absolutely love rad onc and will only accept an academic job, now is the time to apply. In a few years, these top grads will be competing for legit academic jobs with residents who could barely pass their boards and little to no research experience. They'll get their pick. Last year, a very average academic program explicitly told me how shocked they were to get so many over qualified applicants. In like 4 years, things are going to be very different.
 
RADONC4285 said:
if you absolutely love rad onc and will only accept an academic job, now is the time to apply. In a few years, these top grads will be competing for legit academic jobs with residents who could barely pass their boards and little to no research experience. They'll get their pick. Last year, a very average academic program explicitly told me how shocked they were to get so many over qualified applicants. In like 4 years, things are going to be very different.
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Those programs provably won’t be hiring in 5 years. Very well may be cutting, but will probably love some fellows
 
RickyScott said:
Those programs provably won’t be hiring in 5 years. Very well may be cutting, but will probably love some fellows
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You might be right. Or they might hire at a super low starting salary. I personally advise everyone to stay away from rad onc. But there is a small percentage of top med students who just won't be dissuaded.
 
medgator said:
Any commentary? Neither of their medical schools was mentioned in the tweet and i think that was intentional
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South America? I had one interview from brazil a few years back who was basically an attending who wanted to come to the states.
 
RadsWFA1900 said:
South America? I had one interview from brazil a few years back who was basically an attending who wanted to come to the states.
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Googling one of them yielded a CV that's from the University of Venezuela, looks like she was a research fellow previously at CCF
 
TheWallnerus said:
Cush?... teaching faculty have 100% resident coverage year round and 100% cross coverage existed until only recently. In fact it still exists if a resident calls out sick or gives less than month's notice. So really only eliminated for pre-planned vacations. There is actually limited faculty teaching. A lot of junior faculty turnover recently. Several 2:1 attending:resident rotations, and 3-4:1 at one satellite.
Click to expand...
interesting, had heard it was a pretty happy group of residents
 
salubalu said:
An FMG may be a Luka Doncic and a MD PHD may be a Greg Oden. Please let’s not shame fmgs dos and people not with 300s on step 1
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To be fair. Greg oden was number one draft pick with excellent credentials. Just ended up with bad knees. This would be like getting a stellar applicant who ended up with traumatic brain injury or early onset dementia after matching

The Greg Odens aren’t doing radonc anymore

I have no conflict of interest to report and didn’t attend OSU
 
RadRadRad said:
To be fair. Greg oden was number one draft pick with excellent credentials. Just ended up with bad knees. This would be like getting a stellar applicant who ended up with traumatic brain injury or early onset dementia after matching

The Greg Odens aren’t doing radonc anymore

I have no conflict of interest to report and didn’t attend OSU
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Then again brain damage is a prerequisite
 
salubalu said:
An FMG may be a Luka Doncic and a MD PHD may be a Greg Oden. Please let’s not shame fmgs dos and people not with 300s on step 1
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I am not shaming FMGs. Before rad oncs fall from grace, we wanted our program to take amazing FMGs. But I am strongly opposed to opening the floodgates to FMGs just to fill spots becauee of what it will do to our field in terms of future job prospects. Purely from a supply/demand perspective. I don't blame the applicants at all. They're just looking for a better future. Making 200k in the middle of nowhere is better than not matching at all. I exclusively blame our leadership for completely destroying our field
 
It’s a clean FMG sweep this year, even in more competitive fields like psych (at Harvard)

Times are changing!

 
jondunn said:
It’s a clean FMG sweep this year, even in more competitive fields like psych (at Harvard)

Times are changing!

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How? Is this like an Oxford tier foreign school? Seemed like most mgh matches came from Harvard and other T20s
 
no one wants white males
 
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jondunn said:
It’s a clean FMG sweep this year, even in more competitive fields like psych (at Harvard)

Times are changing!

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Guessing percentage wise, prob more FMGs in rad Onc this year than psych. They've essentially switched places in competitiveness. PR probably doesn't count though as they are a US territory
 
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CurbYourExpectations said:
About the same.

Psych has been increasing spots in the match about as fast as EM. Psych spots - 1556 in 2018 up to 2047 in 2022.

RadOnc trending down 207 in 2019, 176 in 2022. Looking forward to Shah's data on how many we need, anyone know when that is supposed to be done?
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Psych has real demand.... Their median salaries have actually been going up and geographically the market is wide open.

EM in the same boat as rad Onc, but i believe many of their residency slots came from greedy hospital chains like HCA rather than the Potters and Hallahans of their specialty
 
CurbYourExpectations said:
About the same.

Psych has been increasing spots in the match about as fast as EM. Psych spots - 1556 in 2018 up to 2047 in 2022.

RadOnc trending down 207 in 2019, 176 in 2022. Looking forward to Shah's data on how many we need, anyone know when that is supposed to be done?

We are the only specialty in the match with positions decreasing. Even EM went up almost 100 spots this year from last year with a projected oversupply of 9000 physicians in 10 years. 🙁
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These numbers are concerning.

Looks like the “physician shortage” crowd is winning. There is a shortage in rural areas but the last thing that cities like SF, Boston, NYC, Chicago etc need is more doctors! Fortunately, I plan to move from the northeast to the south or Midwest after med school.

What are some good specialties to match given these numbers? A contrarian play like neurology? Not very competitive, seems less susceptible to scope creep and AI
 
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