Evidence-based demonstration of the tone-deaf RadOnc "leadership"

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elementaryschooleconomics

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I figured this deserved its own thread.

This paper was just published by the intrepid Dr Chowdhary (a person who hopefully continues to be a light in the darkness).

I'll just copy and paste his Tweets:

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I always love when data is published demonstrating how completely out-of-touch the leadership of this field is. No wonder RadOnc applications have fallen off a cliff - any medical student with half a brain should avoid this dumpster fire at all costs.

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While it sucks that it had to happen, it is MOST pleasing to see a resident absolutely destroy Wallner's "argument" with data.
 
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If they didn't cite wikipedia, I refuse to read it.
 
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While it sucks that it had to happen, it is MOST pleasing to see a resident absolutely destroy Wallner's "argument" with data.
Wallner had egg on his face from day 1 when that was published considering he wouldn't have even matched from 2006-2018 in all likelihood. Something about glass houses and stones comes to mind
 
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How is the research output so much higher for “all other specialties” vs radonc. That seems hard to believe. My impression in med school was that research was much more than of priority for radonc vs other fields
 
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Wallner had egg on his face from day 1 when that was published considering he wouldn't have even matched from 2006-2018 in all likelihood. Something about glass houses and stones comes to mind

Wallner should be called out to give a published response letter, boxing keeping his Bs on the record for people to look back at. Also Someone should look into close auditing of Wallners billing history high chance he’s gaming the system
 
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Wallner had egg on his face from day 1 when that was published considering he wouldn't have even matched from 2006-2018 in all likelihood. Something about glass houses and stones comes to mind

I used to laugh in residency when older attendings would pull out the "I would never have matched in these days" line. Given what these "leaders" have done to the field, I don't find their admissions of mediocrity amusing anymore.
 
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Wallner should be called out to give a response with a published response letter. Also Someone should look into close auditing of Wallners billing history high chance he’s gaming the system

Paul Wallner, Senior VP of 21C, the most ethical corporate RadOnc practice in the country? I'm sure his billing history is flawless.

If you'll excuse me, I need to make sure my patients are getting their daily diode measurements.
 
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Paul Wallner, Senior VP of 21C, the most ethical corporate RadOnc practice in the country? I'm sure his billing history is flawless.

If you'll excuse me, I need to make sure my patients are getting their daily diode measurements.
If you're going to commit fraud daily, go big, or go home
 
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So,

This is hilarious, I just went to the Twitter page and someone just took a stab at Kachnic haha...
Glad that Mudit stood up for the residents.
I always stand up for my med students, residents, and this is great work from Mudit.

What Wallner and Kachnic did back then was "victim shaming", it was the most stupid and disgusting thing they ever did.
 
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I’ve been sitting on this for awhile, but this is probably the best thread to throw this out into the universe:

CONSPIRACY THEORY: I actually think there’s evidence that the ABR (particularly Paul Wallner) intentionally increased the fail rate of the 2018 RadBio/Physics exams.

Why do I think this?

1) Amdur and Lee publish “Thoughts on the American Board of Radiology Examinations and the resident experience in radiation oncology” on March 13th, 2018, ~4 months before the exams. Within it, they state that “we are concerned that this overemphasis on passing examinations is not in the best interest of our specialty”, and use USMLE scores to argue that “ABR Board Certification examinations are becoming more difficult, [a statement which] depends on comparing standardized tests that all radiation oncology residents take before, during, and after their training”. Similar to Mudit’s paper at the start of this thread, Amdur and Lee observed that by all metrics, RadOnc residents were becoming “better” (at least in an academic/test taking sense) yet spending significantly more time preparing for board exams.

The editorial.
https://www.practicalradonc.org/article/S1879-8500(18)30080-8/fulltext

2) The now infamous Wallner and Kachnic “residents are dumb” editorial is released online on April 10th, 2018, ~3 months before the exams.

3) Key dates:

2018 Exam Day - July 12th, 2018
2018 Score Day - August 24th, 2018

4) Hypothesis: I think Paul Wallner, Senior VP of arguably the most unscrupulous corporate RadOnc practice in America, man who sends threats of lawsuits to women who note that there are no breastfeeding accommodations during ABR exams, would absolutely tweak the cutoffs of exams to “prove” Amdur/Lee and their supporters wrong. The cutoffs weren’t changed tremendously - just enough to demonstrate that “the quality of RadOnc residents has gone down over time”.

I don’t think anyone else at the ABR is involved in this. I think Wallner, as the Executive Director and final arbiter of who passes and who fails, did this on his own. While that may sound crazy, remember that there are no checks and balances to this process. The ABR and their exams are a black box - we’re not allowed to see ANYTHING about this process. I assume all the other volunteers who work on these exams that year had nothing to do with this.

Is this timeline and pattern/history of behavior coincidence? Maybe. I’m sure we’ll never know what actually happened.

#RadOncRocks
 
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RW is now weighing in, haha.
Cannot wait for RW to smash PW and LK...

 
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Amazing. Who knew RO can produce a physician with a backbone.
 
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I’ve been sitting on this for awhile, but this is probably the best thread to throw this out into the universe:

CONSPIRACY THEORY: I actually think there’s evidence that the ABR (particularly Paul Wallner) intentionally increased the fail rate of the 2018 RadBio/Physics exams.

Why do I think this?

1) Amdur and Lee publish “Thoughts on the American Board of Radiology Examinations and the resident experience in radiation oncology” on March 13th, 2018, ~4 months before the exams. Within it, they state that “we are concerned that this overemphasis on passing examinations is not in the best interest of our specialty”, and use USMLE scores to argue that “ABR Board Certification examinations are becoming more difficult, [a statement which] depends on comparing standardized tests that all radiation oncology residents take before, during, and after their training”. Similar to Mudit’s paper at the start of this thread, Amdur and Lee observed that by all metrics, RadOnc residents were becoming “better” (at least in an academic/test taking sense) yet spending significantly more time preparing for board exams.

The editorial.
https://www.practicalradonc.org/article/S1879-8500(18)30080-8/fulltext

2) The now infamous Wallner and Kachnic “residents are dumb” editorial is released online on April 10th, 2018, ~3 months before the exams.

3) Key dates:

2018 Exam Day - July 12th, 2018
2018 Score Day - August 24th, 2018

4) Hypothesis: I think Paul Wallner, Senior VP of arguably the most unscrupulous corporate RadOnc practice in America, man who sends threats of lawsuits to women who note that there are no breastfeeding accommodations during ABR exams, would absolutely tweak the cutoffs of exams to “prove” Amdur/Lee and their supporters wrong. The cutoffs weren’t changed tremendously - just enough to demonstrate that “the quality of RadOnc residents has gone down over time”.

I don’t think anyone else at the ABR is involved in this. I think Wallner, as the Executive Director and final arbiter of who passes and who fails, did this on his own. While that may sound crazy, remember that there are no checks and balances to this process. The ABR and their exams are a black box - we’re not allowed to see ANYTHING about this process. I assume all the other volunteers who work on these exams that year had nothing to do with this.

Is this timeline and pattern/history of behavior coincidence? Maybe. I’m sure we’ll never know what actually happened.

#RadOncRocks

I have thought this as well, although you have articulated the timeline better. There are a number of people who think Darth Wallner was offended at Amdur and Lee's post, wrote the editorial, and thus tweaked the exams in 2019 to fail folks so he could go "look at how much they're failing!". I remember hearing that at the round-table discussion at ASTRO with Kachnic the following year with PDs and aPDs, multiple folks just asked "why can't the bar for failure be raised" and were given the same bull**** about the Angoff method that was the defense of it. I was told that apparently ABR HAD changed the passing threshold in the past to ensure > 90% pass rates, but were taking a hard stance against doing it again. That being said, those who had to re-take RadBio/Physics pretty much unanimously said the exam in 2020 was miles better than the exam in 2019 in terms of content asked.

The fact that PW still has ANY standing in Rad Onc after all the **** he's done is the biggest indictment of our field and how, regardless of what the boomer generation does in this field, it is almost impossible to unseat them from positions of power. See Wallner, RW, etc.
 
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I have thought this as well, although you have articulated the timeline better. There are a number of people who think Darth Wallner was offended at Amdur and Lee's post, wrote the editorial, and thus tweaked the exams in 2019 to fail folks so he could go "look at how much they're failing!". I remember hearing that at the round-table discussion at ASTRO with Kachnic the following year with PDs and aPDs, multiple folks just asked "why can't the bar for failure be raised" and were given the same bull**** about the Angoff method that was the defense of it. I was told that apparently ABR HAD changed the passing threshold in the past to ensure > 90% pass rates, but were taking a hard stance against doing it again. That being said, those who had to re-take RadBio/Physics pretty much unanimously said the exam in 2020 was miles better than the exam in 2019 in terms of content asked.

The fact that PW still has ANY standing in Rad Onc after all the **** he's done is the biggest indictment of our field and how, regardless of what the boomer generation does in this field, it is almost impossible to unseat them from positions of power. See Wallner, RW, etc.

Given the timeline and the reports of how difficult the 2018 exam was, my competing theory is Amdur and Lee knew that the questions were tweaked and those exams would have a higher failure rate, which is what prompted them to write the March 2018 editorial.

Six of one, half dozen of the other...
 
I’ve been sitting on this for awhile, but this is probably the best thread to throw this out into the universe:

CONSPIRACY THEORY: I actually think there’s evidence that the ABR (particularly Paul Wallner) intentionally increased the fail rate of the 2018 RadBio/Physics exams.

Why do I think this?

1) Amdur and Lee publish “Thoughts on the American Board of Radiology Examinations and the resident experience in radiation oncology” on March 13th, 2018, ~4 months before the exams. Within it, they state that “we are concerned that this overemphasis on passing examinations is not in the best interest of our specialty”, and use USMLE scores to argue that “ABR Board Certification examinations are becoming more difficult, [a statement which] depends on comparing standardized tests that all radiation oncology residents take before, during, and after their training”. Similar to Mudit’s paper at the start of this thread, Amdur and Lee observed that by all metrics, RadOnc residents were becoming “better” (at least in an academic/test taking sense) yet spending significantly more time preparing for board exams.

The editorial.
https://www.practicalradonc.org/article/S1879-8500(18)30080-8/fulltext

2) The now infamous Wallner and Kachnic “residents are dumb” editorial is released online on April 10th, 2018, ~3 months before the exams.

3) Key dates:

2018 Exam Day - July 12th, 2018
2018 Score Day - August 24th, 2018

4) Hypothesis: I think Paul Wallner, Senior VP of arguably the most unscrupulous corporate RadOnc practice in America, man who sends threats of lawsuits to women who note that there are no breastfeeding accommodations during ABR exams, would absolutely tweak the cutoffs of exams to “prove” Amdur/Lee and their supporters wrong. The cutoffs weren’t changed tremendously - just enough to demonstrate that “the quality of RadOnc residents has gone down over time”.

I don’t think anyone else at the ABR is involved in this. I think Wallner, as the Executive Director and final arbiter of who passes and who fails, did this on his own. While that may sound crazy, remember that there are no checks and balances to this process. The ABR and their exams are a black box - we’re not allowed to see ANYTHING about this process. I assume all the other volunteers who work on these exams that year had nothing to do with this.

Is this timeline and pattern/history of behavior coincidence? Maybe. I’m sure we’ll never know what actually happened.

#RadOncRocks

If you go back to the original physics and radbio thread, I posted about this extensively. Your theory is exactly what I posited at the time. I firmly believe Wallner intentionally manipulated the exam failure rates. He published as far back as 2014 when he led a taskforce that hypothesized that resident rad bio instruction was not sufficient outside of large academic centers and went on a fishing expedition to try and prove this.

It is extremely dirty and harmed young trainees and was a very bad look for the field.
Wallner needs to be held accountable, but who will hold him accountable? Everybody told me to just shut up when everyone got passed the next year and it all went away.
The man is a tyrant. He will continue to mess with people's lives unchecked and continue to non-evidence based exam hazing process using threats, intimidation, and lies like the Angoff method.
 
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Amdur/Lee nail it again

https://www.practicalradonc.org/article/S1879-8500(20)30109-0/fulltext

The immediate effect of the current variance between offered positions and qualified applicants is a continuation of a large number of unfilled residency positions. The long-term implications of decreasing interest in radiation oncology is a problem for the future of our field and potentially the nature of cancer care in our country. We strongly recommend that all stakeholders take urgent action to attempt to reverse these negative trends.
 
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The reason for these changes is multifactorial and further discussion of potential causative factors is beyond the scope of our brief report.

Job market. You couldn't reference anything about the job market?

The immediate effect of the current variance between offered positions and qualified applicants is a continuation of a large number of unfilled residency positions.

Except almost all the positions fill in the soap or post-soap. So are they really unfilled?
 
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