Bleak new data from ASTRO 2020: decreased retirement of practicing RadOncs, Fellowships have doubled

[elementaryschooleconomics]

I figured this deserved its own thread, since I had faculty throw the "we don't know who's retiring" argument at me just last week (implying people are leaving the specialty fast enough to offset people joining the specialty).

A poster from ASTRO 2020 looked at patterns of retirement among Radiation Oncologists:

Salient points:

The worst part about this? The >64 year old workforce are all from the pre-expansion years. The massive expansion in residency numbers are from the last 20 years, meaning, if they followed the traditional path, the earliest expansion doctors should be ~52 years old (enter medical school between 22-24, graduate at 26-28, finish RadOnc residency 31-33, +20 years = 51-53 years old). Even the non-trads are usually <40 when finishing residency.

So essentially we're now being squeezed from both ends? Since this data is from 2006-2017 it does not take into account the current COVID crisis, but it does catch the financial crisis of 2008, which might explain decreased retirement (otherwise, I'm not really sure why the Boomers are hanging on...other than greed).

I know I posted this in the Twitter thread, but here's a second poster which shows the number of RadOnc Fellows has increased from 20 to 42 per year:

So for those playing along at home, we have:

1) 127% increase in the number of RadOnc residencies
2) 110% increase in the number of RadOnc fellows
3) 5% increase in the number of practicing RadOncs delaying retirement

...and of course, decreased utilization (hypofrac), decreased supervision requirements, decreased reimbursement (Alternative Payment Model).

Let's see what the ARRO panels and Terry Wall data look like!

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[RickyScott]

I can tell you that less than 100 radonc retire per year. Fact that we are committed to graduating 1200 over the next 6 years means that even with total residency freeze on incoming classes for 10 years, we will still be up the creek in early 2030s. This is what is so vile about leadership of Astro.

guys like Steinberg, Harrison, Curran, only care about money, prestige , power.. Academics is just the convenient/useful theology of their cult.

 

[medgator]

I know several 60+ y/o rad oncs who are still doing PT or locums work. Now with supervision changes, even they are hurting, as evidenced by the recent change in tone and message from comphealth and other locums agencies.

The newest line of work picking up non practicing docs these days seems to be AIM and evicore, sadly

 

[RickyScott]

I know several 60+ y/o rad oncs who are still doing PT or locums work. Now with supervision changes, even they are hurting, as evidenced by the recent change in tone and message from comphealth and other locums agencies.

The newest line of work picking up non practicing docs these days seems to be AIM and evicore, sadly

In my 15+ year career, I have known (of !) exactly one radiation oncologist who completely retired. The other who left the field was an attending in residency who died several years ago.

 

[FrostyHammer]

I figured this deserved its own thread, since I had faculty throw the "we don't know who's retiring" argument at me just last week (implying people are leaving the specialty fast enough to offset people joining the specialty).

A poster from ASTRO 2020 looked at patterns of retirement among Radiation Oncologists:

View attachment 321256

Salient points:

View attachment 321258

View attachment 321259

The worst part about this? The >64 year old workforce are all from the pre-expansion years. The massive expansion in residency numbers are from the last 20 years, meaning, if they followed the traditional path, the earliest expansion doctors should be ~52 years old (enter medical school between 22-24, graduate at 26-28, finish RadOnc residency 31-33, +20 years = 51-53 years old). Even the non-trads are usually <40 when finishing residency.

So essentially we're now being squeezed from both ends? Since this data is from 2006-2017 it does not take into account the current COVID crisis, but it does catch the financial crisis of 2008, which might explain decreased retirement (otherwise, I'm not really sure why the Boomers are hanging on...other than greed).

I know I posted this in the Twitter thread, but here's a second poster which shows the number of RadOnc Fellows has increased from 20 to 42 per year:

View attachment 321263

View attachment 321264

View attachment 321265

So for those playing along at home, we have:

1) 127% increase in the number of RadOnc residencies
2) 110% increase in the number of RadOnc fellows
3) 5% increase in the number of practicing RadOncs delaying retirement

...and of course, decreased utilization (hypofrac), decreased supervision requirements, decreased reimbursement (Alternative Payment Model).

Let's see what the ARRO panels and Terry Wall data look like!

View attachment 321266

Random thought: why did he put his own picture on the poster? Who does that? I don't know him but this move seems pretentious ASF.

 

[elementaryschooleconomics]

Random thought: why did he put his own picture on the poster? Who does that? I don't know him but this move seems pretentious ASF.

Eh it made sense to me, in the current world where no one gets to do face-to-face things anymore, having a picture of someone helps me remember who does what - not sure of his personal reasons though.

 

[RickyScott]

Random thought: why did he put his own picture on the poster? Who does that? I don't know him but this move seems pretentious ASF.

Maybe hoping to improve visibility because jobs are so hard to come by

 

[DebtRising]

And this is why I argued that the current board recertification / OLA for currently practicing physicians is an absolute joke. ABR with ASTRO input changed from a somewhat real exam / reassessment, to this paint by number system that anyone with a pulse can meet.

Sure it’s great we don’t have big hard exams, but the downside is allowing the entrenched previous generation to practice with no reasonable assessment of their competence. This hurts young practitioners AND hurts patients by keeping older, out of touch physicians in place longer. There is a balance of experience versus adoption of new technology, and not having a reasonable way to assess this is insane.

But hey, #radoncrocks . Let’s find ways to get more medical students while simultaneously setting up board recertification’s most difficult step as having a two screen computer setup so you can answer questions in one while having the back up google option in the other.

 

[beamseyeview]

Random thought: why did he put his own picture on the poster? Who does that? I don't know him but this move seems pretentious ASF.

I had the same initial thought, but then I realized ASTRO is virtual this year. Sort of helps to put the face with the research, like during a poster session

 

[thecarbonionangle]

Eh it made sense to me, in the current world where no one gets to do face-to-face things anymore, having a picture of someone helps me remember who does what - not sure of his personal reasons though.

very handsome guy. Don’t hate the player.

 

[elementaryschooleconomics]

very handsome guy. Don’t hate the player.

Agreed, 10/10 would read his research again

 

[OTN]

And this is why I argued that the current board recertification / OLA for currently practicing physicians is an absolute joke. ABR with ASTRO input changed from a somewhat real exam / reassessment, to this paint by number system that anyone with a pulse can meet.

Sure it’s great we don’t have big hard exams, but the downside is allowing the entrenched previous generation to practice with no reasonable assessment of their competence. This hurts young practitioners AND hurts patients by keeping older, out of touch physicians in place longer. There is a balance of experience versus adoption of new technology, and not having a reasonable way to assess this is insane.

But hey, #radoncrocks . Let’s find ways to get more medical students while simultaneously setting up board recertification’s most difficult step as having a two screen computer setup so you can answer questions in one while having the back up google option in the other.

Hard board exams for practicing radoncs wouldn’t change a thing. You really think a practicing radonc would allow him or herself to fail a “hard” board exam, thus destroying his or her career? No chance. Creating an exam that’s so hard that many would fail is politically not remotely possible, and I would argue it’s also not fair.

The only solution at this point is going to include retraining I’m afraid. Cat is loooong out of the bag.

 

[bergonieandtribondeau]

The tragic thing is that you know 100% of all RO residents, and maybe upwards of 70% of all RO attendings, are actually all on the same page about this. The job market is a crisis and these expanded fellowships are a consequence of that. And yet nothing is openly discussed and nothing (except the voluntary contraction of like 5 residency programs this year?) has been done about it. I guarantee you that everyone who sees those poster at ASTRO will nod their head in agreement when they read it. I don't expect anyone to be surprised by the findings.

That's not to say that the results and the presentation of this data isn't important; quite the contrary. I am very happy to see both of these posters at ASTRO. Good on those two residents for broaching and analyzing this topic. I just wish we could actually tackle this issue much more openly and honestly, as I think the vast majority of the field really wants to, but wont. It's this very bizarre elephant in the room that everyone secretly thinks about and knows exists, and occasionally tries to bring up, but isn't ever called out for what it is.

 

[DebtRising]

Hard board exams for practicing radoncs wouldn’t change a thing. You really think a practicing radonc would allow him or herself to fail a “hard” board exam, thus destroying his or her career? No chance. Creating an exam that’s so hard that many would fail is politically not remotely possible, and I would argue it’s also not fair.

The only solution at this point is going to include retraining I’m afraid. Cat is loooong out of the bag.

It doesn’t need to be grueling or hard, sorry if my post came off that way. But it needs to be something reasonable - some anxiety, some repercussions if you fail, otherwise there is not reasonable assessment of ongoing competence. And there is not - you can practice until 99 by filling out multiple choice questions with the ability to search for the answers. That’s insane.

But I do like your retraining idea for those who fail these steps. Since all these benevolent academic people love fellowships offer a remedial fellowship for practicing docs who can’t pass my / a theoretical true reassessment exam. May not be as malleable and desperate as the new grads, but there could be some experiences with that.

 

[scarbrtj]

I figured this deserved its own thread, since I had faculty throw the "we don't know who's retiring" argument at me just last week (implying people are leaving the specialty fast enough to offset people joining the specialty).

A poster from ASTRO 2020 looked at patterns of retirement among Radiation Oncologists:

View attachment 321256

Salient points:

View attachment 321258

View attachment 321259

The worst part about this? The >64 year old workforce are all from the pre-expansion years. The massive expansion in residency numbers are from the last 20 years, meaning, if they followed the traditional path, the earliest expansion doctors should be ~52 years old (enter medical school between 22-24, graduate at 26-28, finish RadOnc residency 31-33, +20 years = 51-53 years old). Even the non-trads are usually <40 when finishing residency.

So essentially we're now being squeezed from both ends? Since this data is from 2006-2017 it does not take into account the current COVID crisis, but it does catch the financial crisis of 2008, which might explain decreased retirement (otherwise, I'm not really sure why the Boomers are hanging on...other than greed).

I know I posted this in the Twitter thread, but here's a second poster which shows the number of RadOnc Fellows has increased from 20 to 42 per year:

View attachment 321263

View attachment 321264

View attachment 321265

So for those playing along at home, we have:

1) 127% increase in the number of RadOnc residencies
2) 110% increase in the number of RadOnc fellows
3) 5% increase in the number of practicing RadOncs delaying retirement

...and of course, decreased utilization (hypofrac), decreased supervision requirements, decreased reimbursement (Alternative Payment Model).

Let's see what the ARRO panels and Terry Wall data look like!

View attachment 321266

Want to point out the discrepant numbers that appear when one attempts to answer question of "How many rad oncs are there in America in any given year?" As the folks from The Ohio State U show on their poster:

However, as I had shown before:
Per the AAMC in 2017...

And this detailed paper from 2014 gave an estimate for the number of rad oncs in 2012:

So to summarize:

SOURCE	NUMBER OF RAD ONCS & YEAR
	2006	2012	2017
Not The Ohio State		3277	5029
The Ohio State	4077	4575 (interpolated)	4945

On average, these two sources are 20% discrepant. Now TBH I think the 2012 number cited as 3,277 rad oncs in America is/was low. But if The Ohio State is saying ~21% growth in rad oncs over 11 years, I am giving you very conflicting, openly published data that the growth rate in rad oncs is higher than this. But my point is we need really ***accurate*** data as we try to wrap our minds around 1) how bad the oversupply is, and 2) (my personal fascination) how bad the oversupply is going to get.

 

[elementaryschooleconomics]

Want to point out the discrepant numbers that appear when one attempts to answer question of "How many rad oncs are there in America in any given year?" As the folks from The Ohio State U show on their poster:

However, as I had shown before:
Per the AAMC in 2017...

And this detailed paper from 2016 gave an estimate for the number of rad oncs in 2012:

So to summarize:

SOURCE	NUMBER OF RAD ONCS & YEAR
	2006	2012	2017
Not The Ohio State		3277	5029
The Ohio State	4077	4575 (interpolated)	4945

On average, these two sources are 20% discrepant. Now TBH I think the 2012 number cited as 3,277 rad oncs in America is/was low. But if The Ohio State is saying ~21% growth in rad oncs over 11 years, I am giving you very conflicting, openly published data that the growth rate in rad oncs is higher than this. But my point is we need really ***accurate*** data as we try to wrap our minds around 1) how bad the oversupply is, and 2) (my personal fascination) how bad the oversupply is going to get.

I was waiting for you to post this, haha.

I agree, we really need accurate data here. I'm not entirely sure where this discrepancy is coming from, since you're both using AAMC data (I see exactly where you, @scarbrtj, got your numbers, I'm having trouble finding where Ohio got their 4,945 number).

I also think they're likely underestimating things, but this is the first time (to my knowledge) someone has presented a published (even in abstract form) argument that there's an increase in the number of RadOncs delaying retirement, which is absolutely devastating. AT THE VERY LEAST we could hope for a steady amount of people retiring, AT BEST we could have an increase in folks retiring...but it appears we're at the WORST case scenario of non-expansion era RadOncs delaying their retirement.

Let's see if we can uncover this 4,945 source.

 

[scarbrtj]

I was waiting for you to post this, haha.

I agree, we really need accurate data here. I'm not entirely sure where this discrepancy is coming from, since you're both using AAMC data (I see exactly where you, @scarbrtj, got your numbers, I'm having trouble finding where Ohio got their 4,945 number).

I also think they're likely underestimating things, but this is the first time (to my knowledge) someone has presented a published (even in abstract form) argument that there's an increase in the number of RadOncs delaying retirement, which is absolutely devastating. AT THE VERY LEAST we could hope for a steady amount of people retiring, AT BEST we could have an increase in folks retiring...but it appears we're at the WORST case scenario of non-expansion era RadOncs delaying their retirement.

Let's see if we can uncover this 4,945 source.

Based on my field studies, it appears to me that the species Homo retirus radoncilis has almost become extinct beginning around 2015...

 

[RickyScott]

Since so many radoncs created in last 20 years, very few proportionately are retirement age and those that are, don’t retire!

 

[Mandelin Rain]

Since so many radoncs created in last 20 years, very few proportionately are retirement age and those that are, don’t retire!

This is the exact problem

 

[Chartreuse Wombat]

This is the exact problem

And those that are of retirement age think...I am getting paid well for sitting in front of a computer circling targets and posting non-stop on SDN/MedNet and ROHub...life is good

For those with an academic title they have "learners" to do most of the work...why would anyone retire?

 

[fiji128]

Since being in the speciality since 2011 I have known only one rad onc in my orbit to have retired and I think they were >70 years old. Were I currently practice I suspect the two >60 year old rad oncs will die practing rather then ever retiring (not even kidding).

 

[elementaryschooleconomics]

Timely poster...interesting interpretation.

Consistent with what has been said earlier in this thread, this data indicates ~130 RadOncs are retiring/leaving the profession every year...so we're "only" increasing the supply by 70 per year.

Erin, I presume from your winky emoticon this is "gotcha" data in your opinion? This is terrible. Significant retirement activity would give us a 1:1 new grad produced : practicing RadOnc leaving. When you're cranking out ~200 people are year, ~130 leaving does not cut it.

 

[elementaryschooleconomics]

Other conclusions from the poster:

@scarbrtj, care to comment on the increase in beneficiaries per RadOnc?

Also, would anyone care to comment on the fact that they used Medicare Data to estimate RadOnc numbers, instead of the explicit numbers provided by the AAMC?

 

[scarbrtj]

View attachment 321321

Timely poster...interesting interpretation.

Consistent with what has been said earlier in this thread, this data indicates ~130 RadOncs are retiring/leaving the profession every year...so we're "only" increasing the supply by 70 per year.

Erin, I presume from your winky emoticon this is "gotcha" data in your opinion? This is terrible. Significant retirement activity would give us a 1:1 new grad produced : practicing RadOnc leaving. When you're cranking out ~200 people are year, ~130 leaving does not cut it.

Also,

THIS ASSUMES THE 70/YEAR IS A CORRECT NUMBER

I THINK -- BECAUSE DATA --- THAT 70/YEAR IS SIGNIFICANTLY INCORRECTLY LOW

I mean, if I'm reading graph correctly, we're now saying there are ~4600 rad oncs in 2017? And ~4200 in 2012?

Pick a number, folks. Pick a number.
Or *don't* pick *a* number and try and use a diversified range of data to pick a *reasonable* number.

 

[Mandelin Rain]

If even 1 rad onc retires, I consider it significant.

 

[RickyScott]

Would love to hear from residents in large departments with lots of satellites how many radonc completely retired during their residency.

 

[elementaryschooleconomics]

Would love to hear from residents in large departments with lots of satellites how many radonc completely retired during their residency.

I fit that bill - in the past 5 years, to the best of my knowledge, we've had one retire in the traditional sense, and one retire because of health reasons. There might have been a third retirement 5-7 years ago?

 

[elementaryschooleconomics]

Also,

THIS ASSUMES THE 70/YEAR IS A CORRECT NUMBER

I THINK -- BECAUSE DATA --- THAT 70/YEAR IS SIGNIFICANTLY INCORRECTLY LOW

I mean, if I'm reading graph correctly, we're now saying there are ~4600 rad oncs in 2017? And ~4200 in 2012?

Pick a number, folks. Pick a number.
Or *don't* pick *a* number and try and use a diversified range of data to pick a *reasonable* number.

Yes, I think the graph only shows 4600-4700 in 2017, which is lowballing the AAMC number of 5029. At least in this case, I assume there are people the AAMC has captured as Radiation Oncologists who aren't billing Medicare for whatever reason (which we could speculate about).

 

[ROResident]

Would love to hear from residents in large departments with lots of satellites how many radonc completely retired during their residency.

Also at a program like this. We’ve had 4 attendings who are over 60, since I’ve been here. One recently transferred to another academic program, one semi-retired for health reasons a few years back and then returned to full time work in a pp. Two are still here, highest paid in the dept (apart from chair), treating a handful of patients a month and dabbling in research, with no plans for retirement in site.

 

[RickyScott]

personally know of more radoncs who went to evercore or are unemployed >full on retired. Can’t translate lack of billing 1:1 into retirement.

 

[RadRadRad]

Interesting how things vary by region. In my area most of the main senior radoncs retired around age 60...granted they practiced in the golden era and did well financially but I think they also had the perspective to know that life is short and your health is not guaranteed

 

[Chartreuse Wombat]

The human understanding when it has once adopted an opinion (either as being the received opinion or as being agreeable to itself) draws all things else to support and agree with it. -Francis Bacon

These authors have an incentive to bring more people into RadOnc and will decide for us what the "real" numbers are. Some are nepotists as well.

 

[elementaryschooleconomics]

The human understanding when it has once adopted an opinion (either as being the received opinion or as being agreeable to itself) draws all things else to support and agree with it. -Francis Bacon

These authors have an incentive to bring more people into RadOnc and will decide for us what the "real" numbers are. Some are nepotists as well.

To spin oversupply so blatantly into a positive statement - "the total number of Radiation Oncologists increased by 70 providers a year, indicating significant retirement activity given the number of graduating residents", feels like taking a page out of the 2020 American politics playbook.

This is doublethink incarnate.

 

[thecarbonionangle]

WOW folks the spin machines are out in full force with these BS “posters”

 

[salubalu]

Random thought: why did he put his own picture on the poster? Who does that? I don't know him but this move seems pretentious ASF.

Y’all don’t do this? I at least try to show my six pack...#newb

 

[FrostyHammer]

View attachment 321321

Timely poster...interesting interpretation.

Consistent with what has been said earlier in this thread, this data indicates ~130 RadOncs are retiring/leaving the profession every year...so we're "only" increasing the supply by 70 per year.

Erin, I presume from your winky emoticon this is "gotcha" data in your opinion? This is terrible. Significant retirement activity would give us a 1:1 new grad produced : practicing RadOnc leaving. When you're cranking out ~200 people are year, ~130 leaving does not cut it.

Erin Gillespie is a Hall of Fame gaslighter. Her talents in that area are just incredible. Wow.

 

[thecarbonionangle]

With the wink of an eye she said “all is good, i like warm bodies”

 

[radiation]

40+ fellowships, but in 2019 only 4 identified US grads taking fellowship?

https://www.redjournal.org/article/S0360-3016(20)34445-X/fulltext

 

[Doctorer]

40+ fellowships, but in 2019 only 4 identified US grads taking fellowship?

https://www.redjournal.org/article/S0360-3016(20)34445-X/fulltext

View attachment 321345

I don't think this is strange. Every chairman and/or large PP would love to hire a board eligible radonc for a PGY-6+ salary. Doesn't mean they'll be lucky enough to actually find someone.

 

[OTN]

How Dr. Benjamin Smith is still allowed within 100 yards of any workforce study is beyond me.

 

[Mandelin Rain]

40+ fellowships, but in 2019 only 4 identified US grads taking fellowship?

Totally passes the sniff test, IMO.

Nothing to see here.

 

[deleted605854]

Totally passes the sniff test, IMO.

Nothing to see here.

 

[RickyScott]

If I had a choice right now between a really bad job and a fellowship, would go for the bad job, knowing market will be even worse next year.

 

[scarbrtj]

Would one implication be that if America is making ~200 rad oncs a year. And offering 40 fellowship slots a year. But only 4/200 residents take fellowship slots per year. Then 36 slots a year are being filled by foreign grads and America is “at risk” of actually

CREATING MORE RAD ONCS

than what are graduated from all residency programs? Am I misinterpreting? Ie we are “trying” to make ~230 rad oncs a year?

 

[deleted941485]

Would one implication be that if America is making ~200 rad oncs a year. And offering 40 fellowship slots a year. But only 4/200 residents take fellowship slots per year. Then 36 slots a year are being filled by foreign grads and America is “at risk” of actually

CREATING MORE RAD ONCS

than what are graduated from all residency programs? Am I misinterpreting? Ie we are “trying” to make ~230 rad oncs a year?

Oh course why not?

This is where EBM bites you in the ass because it allows you to deliberately obfuscate and deny the obvious under the guise of lack of data.

 

[elementaryschooleconomics]

From "ARRO Seminar 06: Preserving Radiation Oncology by Investing in Training":

On the concerns about residency expansion -
"I think it's important to recognize that we have not necessarily established a direct correlation between the concerns of the residents, in terms of getting a job, and the fact that the number of available [graduating] residents on any given year has gone up over the last couple of years. So, I think it's important to frame the concerns as legitimate and as something that's real to every graduating resident. It's the first time in 10 years of their lives that they're actually untethered, to some extent, and the anxiety and the concerns that are associated with graduating is real, and I think that's real across the board. But from my perspective it's not completely clear that there's a direct relationship to the ability to get a job and the number of graduating residents each year. And, on a personal note, I can say that 30 years ago when I finished training, that there were, in fact, the same concerns, and in the 30 years that I've been practicing we've gone through at least two serious iterations of discussions about the job market. And, it's important to frame that in the sense that however many Radiation Oncologists there are in the United States, maybe 4,500 or thereabouts, we're a tiny, tiny specialty and in any given year the market is going to be good or bad. And that creates anxiety."

- Louis Potters, MD, FASTRO, Chair of Hofstra/Northwell

1) Residents, it's all in your head. There's no data for this!
2) Expansion has been going on for almost 20 years, not "a couple"
3) It's 5,000 RadOncs in America, not 4,500 - 500 is a big number in a small specialty
4) Yes, another classic "sky is always falling in RadOnc" argument without historical context
5) He also said taking only 1 resident this year instead of 2 likely isn't permanent; implied it was an optics move for medical students

I don't have the emotional energy to transcribe more of this with other panelists, but I'll try to recharge and head back in eventually.

 

[scarbrtj]

3) It's 5,000 RadOncs in America, not 4,500 - 500 is a big number in a small specialty

Leaders... please get a handle on what the actual number is. Please. For everyone's sake it's getting very important to know vs guesstimate.

 

[evilbooyaa]

From "ARRO Seminar 06: Preserving Radiation Oncology by Investing in Training":

On the concerns about residency expansion -
"I think it's important to recognize that we have not necessarily established a direct correlation between the concerns of the residents, in terms of getting a job, and the fact that the number of available [graduating] residents on any given year has gone up over the last couple of years. So, I think it's important to frame the concerns as legitimate and as something that's real to every graduating resident. It's the first time in 10 years of their lives that they're actually untethered, to some extent, and the anxiety and the concerns that are associated with graduating is real, and I think that's real across the board. But from my perspective it's not completely clear that there's a direct relationship to the ability to get a job and the number of graduating residents each year. And, on a personal note, I can say that 30 years ago when I finished training, that there were, in fact, the same concerns, and in the 30 years that I've been practicing we've gone through at least two serious iterations of discussions about the job market. And, it's important to frame that in the sense that however many Radiation Oncologists there are in the United States, maybe 4,500 or thereabouts, we're a tiny, tiny specialty and in any given year the market is going to be good or bad. And that creates anxiety."

- Louis Potters, MD, FASTRO, Chair of Hofstra/Northwell

1) Residents, it's all in your head. There's no data for this!
2) Expansion has been going on for almost 20 years, not "a couple"
3) It's 5,000 RadOncs in America, not 4,500 - 500 is a big number in a small specialty
4) Yes, another classic "sky is always falling in RadOnc" argument without historical context
5) He also said taking only 1 resident this year instead of 2 likely isn't permanent; implied it was an optics move for medical students

I don't have the emotional energy to transcribe more of this with other panelists, but I'll try to recharge and head back in eventually.

I imagine this is like being stuck with the eyes pried open in A Clockwork Orange. We appreciate you powering through all this. I had a headache from reading the gaslighting on twitter today.

 

[Doctorer]

From "ARRO Seminar 06: Preserving Radiation Oncology by Investing in Training":

On the concerns about residency expansion -
"I think it's important to recognize that we have not necessarily established a direct correlation between the concerns of the residents, in terms of getting a job, and the fact that the number of available [graduating] residents on any given year has gone up over the last couple of years. So, I think it's important to frame the concerns as legitimate and as something that's real to every graduating resident. It's the first time in 10 years of their lives that they're actually untethered, to some extent, and the anxiety and the concerns that are associated with graduating is real, and I think that's real across the board. But from my perspective it's not completely clear that there's a direct relationship to the ability to get a job and the number of graduating residents each year. And, on a personal note, I can say that 30 years ago when I finished training, that there were, in fact, the same concerns, and in the 30 years that I've been practicing we've gone through at least two serious iterations of discussions about the job market. And, it's important to frame that in the sense that however many Radiation Oncologists there are in the United States, maybe 4,500 or thereabouts, we're a tiny, tiny specialty and in any given year the market is going to be good or bad. And that creates anxiety."

- Louis Potters, MD, FASTRO, Chair of Hofstra/Northwell

1) Residents, it's all in your head. There's no data for this!
2) Expansion has been going on for almost 20 years, not "a couple"
3) It's 5,000 RadOncs in America, not 4,500 - 500 is a big number in a small specialty
4) Yes, another classic "sky is always falling in RadOnc" argument without historical context
5) He also said taking only 1 resident this year instead of 2 likely isn't permanent; implied it was an optics move for medical students

I don't have the emotional energy to transcribe more of this with other panelists, but I'll try to recharge and head back in eventually.

Yup, I felt he was similarly tone deaf and the panel didn't really bring a whole lot to the table.

In any case, "the market has spoken:" a 50% drop in medical student applicants to the specialty can't be spun as being due only due to some fear mongering online. The sooner leaders like Lou acknowledge that, the sooner we can figure out productive ways of moving forward. Unfortunately, it seems like we've got a ways to go.

 

[fiji128]

From "ARRO Seminar 06: Preserving Radiation Oncology by Investing in Training":

On the concerns about residency expansion -
"I think it's important to recognize that we have not necessarily established a direct correlation between the concerns of the residents, in terms of getting a job, and the fact that the number of available [graduating] residents on any given year has gone up over the last couple of years. So, I think it's important

I've noticed that a lot of the stuff on Twitter and here above are now using the verbiage "a job." Rad onc is great! Sign up! Our surveys show you will get "a job!" Concerns are way over blown because grads are still getting "a job." Does any other specialty (except maybe pathology) sell its self to med students by saying you can "a job, nos." This sets the bar so low that any data that our impotent "leadership" cooks up will look good. Kinda like the law schools that claim 90% of their grads are employed 6 months after graduation (baristas included).

Louis Potters created a program in suburban Long Island that was not needed and is approved for 8 residents. The first class of residents from his program only graduated in 2016. I think both from that first class had to do fellowships because they could not find "a job" that was acceptable to them after residency.

Why these people are taken so seriously and given such a platform speaks volumes about what ASTRO is and who they are and who they represent. Even with the number of spots vs number of US MD applicants being 2:1 you can't even get these folks to talk about what is really going here.