One of the troubles for an applicant is the fact that great hospitals, with striking frequency, have awful radiation oncology Depts. This is because medical and surgical oncologists usually hate radiation and have for decades lived with the dream of wiping radiation oncology off the face of the earth. Some "Top" cancer centers will actually intentionally change referral patterns and dept practices so that the radiation oncologists have as little power as possible. However, this tends NOT to be the trend at dedicated cancer INSTITUTIONS (MDACC, MSKCC, FCCC) - versus hospitals with an oncology center, orthopedics center, and cardiology center, etc). At hospitals that have a cancer center, orthopedics center, cardiology center, and rehab center, etc (and are NOT dedicated cancer institutions), the cancer center has a director (usually a medical oncologists who hates radiation) that has to fight at the hospital board meeting for dollars against the cardiology center, orthopedic center, etc. As a result, what dollars the cancer center gets their hands on (even if most of the dollars are coming from the rad onc department) goes to medical oncology and surgical oncology.
There is a big difference between a great hospital, great cancer center, or even a "great" radiation oncology department, and a truly great radiation oncology residency program.
