To the Editor: The Brief Report “Expanding the number of trainees
in radiation oncology: Has the pendulum swung too far” by Shah
(1) has provoked considerable reaction from senior members of the
radiation oncology community, and three such letters are published
above (2-4). In addition, others have voiced concern that whereas
the number of residency places has indeed increased from 93 to 171
between 2001 and 2012, a further look back shows that the number
had actually been in decline before 2001, with that year
representing a nadir. The number of places in 1995 was 137, and
that had represented a steady state in the early 1990s. Thus,
although the increase in residency places was indeed 84% from
2001, it is only 25% from 1995da considerably less dramatic rise
and one perhaps more consistent with an expanding specialty.
Anthony Zietman, MD
Editor-in-Chief
Massachusetts General Hospital
Boston, Massachusetts
http://dx.doi.org/10.1016/j.ijrobp.2013.05.035
References
1. Shah C. Expanding the number of trainees in radiation oncology: Has the
pendulumswung too far? IntJRadiatOncolBiolPhys 2013;85:1157-1158.
2. Lee WR. In regard to Shah. Int J Radiat Oncol Biol Phys 2013;86:596.
3. Wallner P, Shrieve DC. In regard to Shah. Int J Radiat Oncol Biol Phys
2013;86:596-597.
4. Hallahan DE, Perkins SM. In regard to Shah. Int J Radiat Oncol Biol
Phys 2013;86:597.
In Reply to Lee, Wallner, and Hallahan
To the Editor: I would like to thank those who have responded for
their interest and have attempted to address the issues raised (1-5).
One letter noted that medical students should be able to understand
job market dynamics as part of their specialty choices. However, as
the authors also note, applicants are of increasing quality and often
start their radiation oncology experiences as first- or second-year
medical students, 8 to 9 years before residency graduation. It is
nearly impossibledand unrealistic in my opiniondto accurately
assess trends in residency positions and their impact on workforce
needs nearly a decade in advance. Therefore, I do not see my
position as that of paternalistic elder; on the contrary, my position
comes from the standpoint of a recent graduate who went through
the job search along with many of his colleagues and also someone
who currently mentors residents searching for jobs.
With regard to the Accreditation Council for Graduate Medical
