Going into RadOnc PGY2 in 4 months

[blueMD]

hey folks,

its been a while and i can't believe time has gone by so fast, hope everyone is surviving internship. i remember a year ago i was praying just to match into residency haha

so to the point, any recommendation from seniors as to what we should do prior to going into our rad onc residencies? a friend pgy2 recommended going over jncc guidelines but i also wanted a feel from upper level residents. if you could go back in time a few months before starting pgy 2 wat would u have done differently? thanks peepz.

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[Gfunk6]

Believe me, when I was in your shoes 12 months ago I was nipping at the bud to get started. I picked up a bunch of textbooks/handbooks and tried to dive into some RadOnc related topics during those long call nights.

Ultimately, it was very low yield. The RadOnc learning curve in the first few months is STEEP and nothing you review will help you much. Since you are not rotating through a RadOnc service currently, the information won't stick either.

My advice would be to continue to absorb medicine/surgery as much as you can.

 

[clintpark]

I agree with GFunk. I would only add that you get Step III out of the way if you haven't done so already.

 

[qwert]

I'll disagree with above comments. You definately wanna buy Hansen's "Handbook of RadOnc" and start going over it, at least staging. First few months can be quite overwhelming.

hey folks,

its been a while and i can't believe time has gone by so fast, hope everyone is surviving internship. i remember a year ago i was praying just to match into residency haha

so to the point, any recommendation from seniors as to what we should do prior to going into our rad onc residencies? a friend pgy2 recommended going over jncc guidelines but i also wanted a feel from upper level residents. if you could go back in time a few months before starting pgy 2 wat would u have done differently? thanks peepz.

 

[clintpark]

I'll disagree with above comments. You definately wanna buy Hansen's "Handbook of RadOnc" and start going over it, at least staging. First few months can be quite overwhelming.

I guess reading about cancer in general such as epidemiology, natural history, staging (althought difficult to memorize it without a patient to put it in context), etc. would be helpful. I really wouldn't stress over rad onc specific stuff. Definitely don't read about trials, etc. (In fact, I wouldn't read about trials --- if your program environment allows it --- for the first year as a resident)

I tend to agree with GFunk that, while it will help to know this stuff, it is just not the best use of your precious time as an intern because you won't have any context to make it stick...

 

[Gfunk6]

I tend to agree with GFunk that, while it will help to know this stuff, it is just not the best use of your precious time as an intern because you won't have any context to make it stick...

I am at the institution where the Hansen/Roach book was published so I felt a special pressure/obligation to go over it prior to my PGY-2. I can only say that for me, personally, it was largely wasted time. As an intern, I enjoyed focusing on common cancers one sees as an Internist in an inpatient setting like lung CA, pancreatic CA, colon CA, etc. along w/ relevant epidemiology, etiology, diagnosis, and overview of treatment.

But memorizing trials, doses, treatment fields is probably not a very good use of your time.

 

[Thaiger75]

I think at the very least, if you can memorize the AJCC staging systems (which doesn't really need any experience to do b/c it's rote memorization), then you will be WAY ahead of the curve. It will be one less (important) thing you will have to memorize when you start.

Make flashcards and memorize!

 

[radiaterMike]

I wouldn't spend too much time with AJCC staging other than to familiarize yourself with it in a general way, since there will be a new edition published within 1-2 years. Obviously once you are in the field as a resident you need to know and understand not only the new staging systems but also the old ones as well (to appreciate what patient populations were included in trials). As an intern, cramming AJCC staging a year or two before it will be modified will be a waste.

Maybe read a good novel or watch the first seasons of lost instead?

I think at the very least, if you can memorize the AJCC staging systems (which doesn't really need any experience to do b/c it's rote memorization), then you will be WAY ahead of the curve. It will be one less (important) thing you will have to memorize when you start.

Make flashcards and memorize!

 

[Thaiger75]

I disagree that it would be a waste. The AJCC staging system for most tumors does not typically change significantly over 1-2 years. And even if there are any changes, they are minor. Unless you know something I don't, the only one that I know of that will change somewhat in the next edition will be NSCLC.

I wouldn't stress about this too much. I would not spend hours staying up late doing this...definitely enjoy your intern year as much as you can...but if you want to study something in rad onc during your intern year...I still think staging is worthwhile. It's not something that you will need context around (unlike trials).

I wouldn't spend too much time with AJCC staging other than to familiarize yourself with it in a general way, since there will be a new edition published within 1-2 years. Obviously once you are in the field as a resident you need to know and understand not only the new staging systems but also the old ones as well (to appreciate what patient populations were included in trials). As an intern, cramming AJCC staging a year or two before it will be modified will be a waste.

Maybe read a good novel or watch the first seasons of lost instead?

 

[qwert]

Changes in the new edition will be minimal.

I wouldn't spend too much time with AJCC staging other than to familiarize yourself with it in a general way, since there will be a new edition published within 1-2 years. Obviously once you are in the field as a resident you need to know and understand not only the new staging systems but also the old ones as well (to appreciate what patient populations were included in trials). As an intern, cramming AJCC staging a year or two before it will be modified will be a waste.

Maybe read a good novel or watch the first seasons of lost instead?

 

[stephew]

wouldnt start any deep memorization of staging systems. particularly if youre doing service oriented rotations. relax. its not efficient to try major pre-studying.

 

[radiaterMike]

I probably overstated the expected changes in the new edition, but I do think that memorizing staging, without a frame of reference (patients you see in clinic or hear about in conferences) is inefficient.

Changes in the new edition will be minimal.

 

[deleted4401]

studying without context is damn near impossible. if it will make you more comfortable to study rad-onc and memorize hansen/roach during the last few months of internship, do it.

i doubt very much that it will make you a better radiation oncologist 5 years and 4 months from now. in fact i'll guarantee it won't.

focus on hating internship. that's what you're supposed to do the last four months of intern year. didn't you read the handbook?

s

 

[IndyXRT]

I agree that no special studying is required. If you are desperate for something to study, staging and the Hansen/Roach book aren't bad ideas. I think it will be low-yield, but it couldn't hurt (apart from wasting precious free time).

 

[blueMD]

thanks for the input. and thanks simul, i will focus on hating internship

 

[deleted4401]

I'm not sure. I think those that hated internship tend to be better rad-oncs, but there is very little level I evidence. My hate wasn't there at the start, and didn't really flourish until internship was nearly over.
S

 

[qwert]

The best thing about the internship was trying to do as little work possible without getting caught. It's amazing how lazy people get when their work doesn't matter.

 

[xraydude]

Here's a better idea.....why don't you just enjoy life. I mean, as an intern you can't tell me you have a ton of free time (maybe the work hours rules have changed things).

You're going to learn the rad onc when you have to.....there's no point to try to learn it now....most of the book knowledge is pure rote memorization, and only is remembered in the context of usefulness. When you start your residency, you'll learn to build a scaffold to attach useful and useless (aka boards info) on. Four years is plenty of time to learn the info....in fact you'll have so much time that you'll also learn all the useful stuff, like anatomy, doses, and managment of complicated patients.

I agree with SimulD. You won't be a better radonc in 5 years by studying now. But you'll have more fun in life if you enjoy this time.

 

[stephew]

Completely agreed.

 

[radonculous]

Completely agreed.

I have been asked by the people coming to our program about what books would be good to buy, and this thread got me thinking that maybe the best thing isn't to buy one of the big honking textbooks but to get a smaller handbook for some light beach reading. So I looked around, and there are a couple handbooks that might be outdated by now. I heard there is a new Haffty-Wilson book coming out in June? July? One of the attendings at our institution wrote a chapter for it. Supposed to have PDA files etc. Sounds like there are lots of other institutions involved. Anyone have confirmation of this?