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Controversial Presentations--your thoughts

Discussion in 'Radiation Oncology' started by Reaganite, Jul 25, 2006.

  1. Reaganite

    Reaganite Member

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    I will be doing an elective rotation in my school's radiation oncology department. I know that I will have to give a presentation, so I figure that I might as well prepare one now while I have some time. I go to an institution that is one of the few centers in the world to use a certain type of radiation treatment. (I'm trying to be non-specific!). There was a recent article in the Red Journal questioning the use of this therapy. I would really like to give a presentation that relates to this article as I have a lot of experience with the treatment that the author is questioning. I am concerned, however, that I might be setting myself up for a big fall as many of the doctors in the department have, from what I hear, defended the treatment at national conferences with their lives! Any thoughts?
     
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  3. MuDPhuDShane

    MuDPhuDShane Junior Member

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    I don't see a problem with presenting the article. If you also support the therapy, you may want to briefly present or at least introduce additional literature which supports the treatment--this way, you're showing your support of the therapy and its clinical value, and hence, you may score some "brownie points" ;)
     
  4. Gfunk6

    Gfunk6 And to think . . . I hesitated
    Physician PhD Faculty Moderator Emeritus Lifetime Donor Classifieds Approved

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    Weren't you in the department where you couldn't do research b/c some faculty felt they were "burned" in the past by med students going elsewhere for residency? This fact, coupled w/ the fact that some faculty defended a certain therapeutic modality "with their lives" = unecessary risk.

    It may be worthwile to do a controversial presentation in certain select cases, but I certainly woudln't do it here. My two cents.
     
  5. MuDPhuDShane

    MuDPhuDShane Junior Member

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    I guess I assumed that you supported the therapy--if you feel different than most of the faculty members, it may not be the appropriate venue to express your feelings... Of course you're entitled to your own opinions regarding the therapy, but who wants a room full of attendings who don't agree with your judgement?
     
  6. Reaganite

    Reaganite Member

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    Yes, I am that guy. (By the way, the faculty was not burned by med students doing their residency elsewhere; they were burned by students who would start a project and not complete it). Speaking of that, I took the advice of people here and spoke with the residents who recommended the guy I am now working with. I was able to get in on a basic science project and recently submitted an abstract to radiation research society. Thank you very much for the advice!

    Regarding this certain therapeutic modality, I will just tell you that I am referring to protons. The January edition of the Red Journal had an article by Eric Hall (who I hear is practically a deity in this field) that questioned the use of these particles. Specifically, he argued that the process by which protons are scattered to generate a field of sufficient size leads to the production of a significant number of neutrons, which substantially increase the dose outside the treatment field. As a result, the secondary cancer risk of protons may be significantly higher than even photon IMRT.
     
  7. stephew

    stephew SDN Super Moderator
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    you can present the article but present it for what it is: controverial. Also you want to talk with profs you work with who will help you develop the points, including what they feel are flaws with this article. The point is as a student you aren't in a position to have strong feelings one way or another on the topic. As a student at a center with a vested (academic and fiscal) interested in the modality, you have toes to watch out for. So present the topic if it interests in context. go over teh data, how it was done, the flaws, and withing the guidelines the attendings help you with.

    Again, you aren't going to be an expert as a student with only the views of a paper and the strong opinion of your attendings. Present the issues and dont editorialize your own views and you should be fine.
    Good luck.
    Steph
     
  8. stephew

    stephew SDN Super Moderator
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    i should add: just because people are well versed in something doesnt mean their views are doctrine. what experts BEST do is raise the pertinant questions. A la Eli Glatstein and his concern that IMRT will incraese 2nd cancer risk. Its a legitimate concern. NO ONE can say we have the concern ergo we KNOW this a problem. Some people have a problem with that last part. THey raise an interesting point and it becomes their baby, they get a vested (intellectual) interest in the outcome. Best just to say "I thought of this question; lets find out" than to say "I thought of it, ergo its true".
     

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