Applying to Radiation Oncology as a DO

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sirspamalot said:
If you go to a top 10 radonc training program you'll be fine. Nobody can predict the pendulum. Horrible in 1997, amazing in 2005, horrible in 2020 it comes and goes. I've made serious 0's in my career, and continue to # it out.

Get good training, network, and be flexible and you too can enjoy this life. Also, "buy low" (e.g. 1997) we may be at another moment here now... justsayin'
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I disagree that you will be fine. Yes, you will get a job when you graduate, but if things don’t work out 5-10 years later at the large malignant academic system, finding another one is not very easy especially if utilization decreases.
 
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DOs aren't what they used to be and DO schools are doing some things right (mainly expanding and expanding in areas that need docs).

I believe that new DOs are now making up roughly 25% of all newly minted US docs, up from roughly 5% not that long ago. We need those docs and as that number increases, the DO stigma will disappear.

I am not sure what has made MD schools so reluctant to expand or encourage new schools, but it is a major issue. The appropriateness of DO expansion is evident in the improvement in relative competitiveness. Differences in MCAT scores between accepted students is much less than it used to be. I just had a DO student rotate through who was extraordinarily sharp.

Radoncs from most of our eras are ridiculously elitist, particularly if we went to a notable program.

Does anyone really think that anyone who graduated in the top 30% of their class at a regular or state school in a STEM field can't get the job done cognitively?

Go DO!

Now I admit, I am a little worried that making the boards pass fail will engrain even more elitism among our most elite institutions. Used to be, you could come from state MD school, crush it and compete with an average Harvard grad for plum spots. Those days may be over.
 
Uh, most of the DO's I've interacted with are not the cream of the crop (outside radonc). I've never really met a DO radonc.

There's a reason people go to DO school instead of Medical School. And the bottom 10% of my med school class was suspect too.

Do the brightest 20% of DO's compete with MD's? Prolly. Hopefully DO schools aren't still teaching voodoo about joint manipulation other than as historical remnant..
 
you’re gonna be fine if you decide to apply but please go to a job listing website and look at available jobs use for eg (merrit hawkins) you’d find less than 10 jobs available in the whole country now go look at med hem/onc jobs or any other specialty and decide for yourself if you are ok with this getting much worse 5-6yrs when you graduate maybe you wouldn’t even find a job in the middle of Arkansas who knows.
 
There were 20+ jobs in my last big email. Many were not in places most folks might be dying to live in, but you can make plenty of $. The more you can geographically arbitrage yourself, the better off you'll be..

and so.. have you ever thought about learning how to fly?

Pilot Ok GIF by Foo Fighters


ps. quality GIF, no upvotes. Me sad.
 
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sirspamalot said:
Uh, most of the DO's I've interacted with are not the cream of the crop (outside radonc). I've never really met a DO radonc.

There's a reason people go to DO school instead of Medical School. And the bottom 10% of my med school class was suspect too.

Do the brightest 20% of DO's compete with MD's? Prolly. Hopefully DO schools aren't still teaching voodoo about joint manipulation other than as historical remnant..
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Your ignorance is amazing.. there are actually a significant number of DO schools especially in competitive areas such as California whose average mcat and gpa’s are higher than some state USMD schools.. DO’s have been actively told to avoid rad onc atleast the last 4-5 years and that’s the main reason why there’s soo few DO’s in Rad onc. Also because 10-15 years ago Rad onc was the most elitist specialty, who wanted only MD phd’s even more so than plastics or neurosurgery nowadays. I mean even plastics and neurosurgery routinely take DO’s nowadays and even derm takes nearly 50-60 DO’s yearly in the combined merged match.. the combined merged match has done wonders for DO’s imho. It’s great to see rad onc fall from grace.. and these same elitist chairs and PD’s are now begging USMD and DO’s to fill their spots so their residency doesn’t straight up shut down now.. it’s quite hilarious.
To OP go into any other average field such as IM, PM&R, anesthesia, even rads, or psych and neurology these are significantly better fields that average USMD and DO’s can get into and get a job afterwards.
 
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sirspamalot said:
There were 20+ jobs in my last big email. Many were not in places most folks might be dying to live in, but you can make plenty of $. The more you can geographically arbitrage yourself, the better off you'll be..

and so.. have you ever thought about learning how to fly?

Pilot Ok GIF by Foo Fighters
Click to expand...
Once you have kids in school or sick elderly parents that you are caring for, geographic arbitrage is out the window. Sure some low IQ, dumb AF medstudents will snag good residencies this cycle and may very well land that vaunted satellite job or DEI fellowship. But, 5-10 years down the road when they simply can’t tolerate the kachnic, dicker, or regine petty despot of a chairman, they are fd no matter where they did their training.
I am in highly desirable metro. Did you train at Harvard? That’s great, but will still have no local escape if the chairman cuts your salary or demotes you.
 
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sirspamalot said:
There were 20+ jobs in my last big email. Many were not in places most folks might be dying to live in, but you can make plenty of $. The more you can geographically arbitrage yourself, the better off you'll be..

and so.. have you ever thought about learning how to fly?
Click to expand...
sam1234567 said:
you’re gonna be fine if you decide to apply but please go to a job listing website and look at available jobs use for eg (merrit hawkins) you’d find less than 10 jobs available in the whole country now go look at med hem/onc jobs or any other specialty and decide for yourself if you are ok with this getting much worse 5-6yrs when you graduate maybe you wouldn’t even find a job in the middle of Arkansas who knows.
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I was saying it’s bad compared to hem/onc and other specialties and yeah if you are willing to work in the middle of no where you can even find a job in nuclear medicine i guess its all relative.
 
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communitydoc13 said:
DOs aren't what they used to be and DO schools are doing some things right (mainly expanding and expanding in areas that need docs).

I believe that new DOs are now making up roughly 25% of all newly minted US docs, up from roughly 5% not that long ago. We need those docs and as that number increases, the DO stigma will disappear.

I
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They basically are taking kids now that 10-20 years ago would have gone Caribbean/sgu/auc/ross (rad onc used to fill with Caribbean grads before the turn of the century...)

They are expanding everywhere not just places that need docs and the big problem will be that residencies are not expanding quick enough to accommodate all of them.

Some of the newer for profit med schools sound like straight up scams honestly

tcf.org

For-Profit Medical Schools, Once Banished, Are Sneaking Back

In Idaho’s 2016 State of the State address, then-governor Butch Otter announced that he was directing the state’s Board of Education to work with the
tcf.org tcf.org
 
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medgator said:
They basically are taking kids now that 10-20 years ago would have gone Caribbean/sgu/auc/ross.
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Yeah. I was shocked to find out that the pretty reputable DO school in my region didn't have a home clinical site. They rotate through a number of community sites during 3rd and 4th years.

Now, lots of MD schools rotate through affiliated community sites, but there is always that home site experience. The uber intense 3rd year home site IM or surgery rotation is probably the most important part of med school IMO. I do think this is a downside of a lot of these programs.

Fact is though, we need more docs and we don't need to import them at the resident level to make things work (nothing against IMGs, its just kinda a crazy thing).

It's almost like in the US and UK, being a doc in community health care is really a job for well educated foreigners while an elite subset of docs who are native born work exclusively in academia or elite urban communities. Other US elites go into things like investment banking.

I don't know, but I do suspect that established MD schools are not really concerned with providing community health care at the MD level. They are interested in prestige, their differential value over community partners and research.

I don't need cream of the crop. I need conscientious and reasonably bright people, who are licensed to do things like prescribe chemo, and who will commit themselves to less glamorous US communities.

I'm more than happy for them to be DOs.
 
sirspamalot said:
Less glamorous, but better pay. Our hospital is desperate for a medonc and would probably pay W2 750k+ easily for a very manageable position. Nobody wants to work in rural America. Cost of living is dirt cheap. But alas..
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Inside joke on this forum, how's the biryani there? That will tell you the answer
 
DOs are fine, don't understand the hate.
My wife practices in a specialty with a lot of DOs. Her residency had probably 1/2 DOs. They are fine. Ultimately, if you are doing the same residency, passing the same board exams, etc there is no tangible difference.
There are good and bad american MDs, foreign MDs, DOs, Carribean grads.
 
sirspamalot said:
Less than 30 minutes from office to rolling down the runway is more like it.

Hell Yeah Snl GIF by Saturday Night Live
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Serious question: How often does weather mess with your flying plans? I've flown in my buddy's Husky before, and he has to change his plans decently frequently due to weather.

Edit: He did let me fly the plane, and it was an absolute blast.
 
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I'd say 10% of the time ice/thunderstorms/very low ceilings or outs limit my flying somewhat. This might mean delaying a few hours, or the next morning. About 2% of the time, I can't show up for another whole day, the staff/leadership are understanding that my nearly 20 years of flying experience will dictate whether or not it is safe to fly. I hate missing work, but I want to arrive. If any question arises, I'll leave and cut my weekend short (or not go home).

That said, you can do everything RIGHT and still nearly die. I almost did a couple days ago, nothing I could do different. Jackass student pilot failing to communicate whatsoever. PM me if you want the details.
 
medgator said:
Maybe even less. Best big city airport i ever saw was KC MO.... Literally could walk in and see ticket counter, security and gate almost immediately from the entrance
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its not as great as it seems. You have a security line for like 5-10 gates at a time, so...at 530AM you got ALOT of people in line. I missed a few flights out of there before.
 
sirspamalot said:
Well, the best I can do is all you can eat sysco chinese buffet.. plus 850k a year.

Deal?

ps. the airport has a nice shiny new runway
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Do you have Friday as a half- or off-day? Because having an airport nearby doesn't end up meaning anything when there are only a few departures a day and the MD has pts until 4:30pm. A lot more people would be willing to consider rural practice if the were confident they could escape on weekends, but positions need to be appropriately structured to accommodate that.

EDIT: I mean for the open med onc position
 
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I'll see your half day and raise you a day and a half. Like the kool-aid guy said growing up.. Oh yeah.

Also I fly whenever I want cause..

(crowd yells in unison: "he's a pilot!")

Ps. Everyone here has a 4 day work week that wants it..
 
Ain't no shame in playin' the game, to win.

Why work like a dog for 30% less pay, zero control of my schedule (or tax efficiency), and not run the shop? Bonus: no hostile administrators or poisonous employees or colleagues to deal with here in nowheresville.

Nothings perfect, but I'd say its..


ned flanders smile GIF
 
sirspamalot said:
Uh, most of the DO's I've interacted with are not the cream of the crop (outside radonc). I've never really met a DO radonc.

There's a reason people go to DO school instead of Medical School. And the bottom 10% of my med school class was suspect too.

Do the brightest 20% of DO's compete with MD's? Prolly. Hopefully DO schools aren't still teaching voodoo about joint manipulation other than as historical remnant..
Click to expand...
DO school is medical school. Take your exact allopathic school experience and add on a sprinkle of extra hands-on utility and a large pile of voodoo, and now you have osteopathic school. It's actually just more work for less reward. It's the tax for doing decent on the MCAT and not great, nowadays, or doing well on the MCAT but being lazy in undergrad.
medgator said:
They basically are taking kids now that 10-20 years ago would have gone Caribbean/sgu/auc/ross (rad onc used to fill with Caribbean grads before the turn of the century...)

They are expanding everywhere not just places that need docs and the big problem will be that residencies are not expanding quick enough to accommodate all of them.

Some of the newer for profit med schools sound like straight up scams honestly

tcf.org

For-Profit Medical Schools, Once Banished, Are Sneaking Back

In Idaho’s 2016 State of the State address, then-governor Butch Otter announced that he was directing the state’s Board of Education to work with the
tcf.org tcf.org
Click to expand...
Might be partially true due to sheer numbers, but I would also point out that the average entry stats just rise every year across the board due to all of the available resources. Even getting into a DO school is becoming very competitive. Ironically, a lot of elitist old-timer doctors you talk to that describe their experience and stats getting into medical school would not even be accepted into DO schools today.
communitydoc13 said:
Yeah. I was shocked to find out that the pretty reputable DO school in my region didn't have a home clinical site. They rotate through a number of community sites during 3rd and 4th years.

Now, lots of MD schools rotate through affiliated community sites, but there is always that home site experience. The uber intense 3rd year home site IM or surgery rotation is probably the most important part of med school IMO. I do think this is a downside of a lot of these programs.

Fact is though, we need more docs and we don't need to import them at the resident level to make things work (nothing against IMGs, its just kinda a crazy thing).

It's almost like in the US and UK, being a doc in community health care is really a job for well educated foreigners while an elite subset of docs who are native born work exclusively in academia or elite urban communities. Other US elites go into things like investment banking.

I don't know, but I do suspect that established MD schools are not really concerned with providing community health care at the MD level. They are interested in prestige, their differential value over community partners and research.

I don't need cream of the crop. I need conscientious and reasonably bright people, who are licensed to do things like prescribe chemo, and who will commit themselves to less glamorous US communities.

I'm more than happy for them to be DOs.
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I agree that DOs have a disadvantage with not having a home site, but I don't think that disadvantage comes in the form of worse or less-rigorous training. It's more of a disadvantage because it requires more travel and provides less research opportunities for becoming competitive. A lot of DO sites tend to give their students a lot of hands-on training because they are community hospitals that actually need the help.

Anyway, I understand the DO stigma, and I think the nature of a lot of the osteopathic training warrants it, but people should at least have an accurate understanding and impression.
 
Swiddy said:
DO school is medical school. Take your exact allopathic school experience and add on a sprinkle of extra hands-on utility and a large pile of voodoo, and now you have osteopathic school. It's actually just more work for less reward. It's the tax for doing decent on the MCAT and not great, nowadays, or doing well on the MCAT but being lazy in undergrad.
Click to expand...

This is a good summary. While there are likely some correlations between effort and commitment in undergrad to possession of the same traits in med school ad beyond, I (an MD) have always told people who ask that the only thing I infer from one's having a DO degree rather than an MD is that undergrad didn't go quite stellarly. Plenty of undergrads change from treating college as a low-stress exploration process to deciding on medicine after a few semesters, and by that time, significant GPA damage may have already been done.
 
Stop this MD vs DO BS(both paths grant an equal ability to practice in any field of medicine in the US) Bottom line is that no US student MD or DO or quite frankly even any IMG should go into the dying field of Radiation Oncolgy…it is essentially the nephrology of residencies
 
Rad Onc is not dying. At least every other patient we discuss in tumor boards has seen or will see Rad Onc. They are quite busy around here. When a hiring crisis really hits, the residencies just need to slash their spots 90% for a couple of years, then moderate to a level maybe 50% of what it is now.
 
Ubba said:
Rad Onc is not dying. At least every other patient we discuss in tumor boards has seen or will see Rad Onc. They are quite busy around here. When a hiring crisis really hits, the residencies just need to slash their spots 90% for a couple of years, then moderate to a level maybe 50% of what it is now.
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Radiation won’t dissapear, but it’s indications lessen (threaten to lessen) every year, unlike almost any other specialty in medicine.
 
Ubba said:
Rad Onc is not dying. At least every other patient we discuss in tumor boards has seen or will see Rad Onc. They are quite busy around here. When a hiring crisis really hits, the residencies just need to slash their spots 90% for a couple of years, then moderate to a level maybe 50% of what it is now.
Click to expand...
Which of course will never happen until the specialty has fallen off the cliff/crashed into the mountain.
 
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DOs are profoundly discriminated against in this specialty (and many others). When you think of real "discrimination" this is so easy to show happening, compared to other types, because not only is it legal, it is enforced by many departments.

If two candidates were literally exactly alike - same letters of rec, same scores, same race, same gender and one was a a DO and one was an MD, the MD will 100% get more interviews and be more likely to match.
 
Ubba said:
Rad Onc is not dying. At least every other patient we discuss in tumor boards has seen or will see Rad Onc. They are quite busy around here. When a hiring crisis really hits, the residencies just need to slash their spots 90% for a couple of years, then moderate to a level maybe 50% of what it is now.
Click to expand...
RealSimulD said:
DOs are profoundly discriminated against in this specialty (and many others). When you think of real "discrimination" this is so easy to show happening, compared to other types, because not only is it legal, it is enforced by many departments.

If two candidates were literally exactly alike - same letters of rec, same scores, same race, same gender and one was a a DO and one was an MD, the MD will 100% get more interviews and be more likely to match.
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Blah blah blah blah… yet every year more DO’s are matching to traditional elite MD programs
As far as discrimination in Radiation oncology that’s an oxymoron. I don’t think a specialty that can’t fill all their spots and only fills like 60-70% and with many US IMG or FMG’s has room to discriminate against anyone.. what a joke. As things stand any US DO who has a pulse can walk into and I really mean WALK into the vast majority of Radiation oncology programs.
 
FutureDoctor5000 said:
Blah blah blah blah… yet every year more DO’s are matching to traditional elite MD programs
As far as discrimination in Radiation oncology that’s an oxymoron. I don’t think a specialty that can’t fill all their spots and only fills like 60-70% and with many US IMG or FMG’s has room to discriminate against anyone.. what a joke. As things stand any US DO who has a pulse can walk into and I really mean WALK into the vast majority of Radiation oncology programs.
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You're a DO at an elite program? Oh wait ...
 
FutureDoctor5000 said:
Blah blah blah blah… yet every year more DO’s are matching to traditional elite MD programs
As far as discrimination in Radiation oncology that’s an oxymoron. I don’t think a specialty that can’t fill all their spots and only fills like 60-70% and with many US IMG or FMG’s has room to discriminate against anyone.. what a joke. As things stand any US DO who has a pulse can walk into and I really mean WALK into the vast majority of Radiation oncology programs.
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Weird tone, but anyway the data doesn't support what you are saying. NRMP supports that it's exactly as difficult as a DO today as it was in 2018.

DO applicants to rad onc have about tripled 2018-2023. In 2018 there were 3 DO graduate matches into RO. In 2023, there were only 9 DO graduates matched (3 of which were not "US senior" grads, so applying after prelim year or some other break).
 
NotMattSpraker said:
Weird tone, but anyway the data doesn't support what you are saying. NRMP supports that it's exactly as difficult as a DO today as it was in 2018.
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So . . . beggars CAN be choosers?
 
NotMattSpraker said:
Weird tone, but anyway the data doesn't support what you are saying. NRMP supports that it's exactly as difficult as a DO today as it was in 2018.

DO applicants to rad onc have about tripled 2018-2023. In 2018 there were 3 DO graduate matches into RO. In 2023, there were only 9 DO graduates matched (3 of which were not "US senior" grads, so applying after prelim year or some other break).
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That’s because the vast majority of DO grads rather stay away from Radiation oncology anyways. What you conveniently fail to mention is the number of FMG who have matched to radiation oncology has ballooned over the last few years as has the number of unfilled spots. I can almost guarantee that any DO student(or even graduate who failed to match their preferred specialty) can walk into a radiation oncology program.
 
I haven't met a 'sharp' DO but I've met plenty of mid ones. Some are certainly seeming to be the same as an average MD.

Hell, I've met some pretty dense MD folks too. But the elite/sharpest of them all? Not a one was DO.
 
sirspamalot said:
I haven't met a 'sharp' DO but I've met plenty of mid ones. Some are certainly seeming to be the same as an average MD.

Hell, I've met some pretty dense MD folks too. But the elite/sharpest of them all? Not a one was DO.
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Wtf does this post even mean…. Hahah get your head out of your a**
 
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