Hellpits- absolute worst programs in radiation oncology

[RickyScott]

Pits of Hell: with match 2023 round the corner, we should revisit the absolute worst programs in radiation oncology. Grads should not expect employment. There is just no legitimate reason for a us md to apply.

Worst of the worst. Us MDs should not attend under any circumstances: West Virgina, Arkansas, Mississippi, MCSC, Tennessee, Baylor Scott and White, Dartmouth, Columbia, SUNY downstate, SUNY upstate, Brooklynn Methodist, Baylor, Stony Brook, Kentucky, Louisville

Garbage: Indiana, Galveston, San Antonio, LIJ, Nebraska, Oklahoma, Mayo-Jack, UC Irvine,

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[Ray D. Ayshun]

Pits of Hell: with match 2023 round the corner, we should revisit the absolute worst programs in radiation oncology. Grads should not expect employment.

Worst of the worst. Us MDs should not attend under any circumstances: West Virgina, Arkansas, Mississippi, MCSC, Tennessee, Baylor Scott and White, Dartmouth, Columbia, SUNY downstate, SUNY upstate, Brooklynn Methodist, Baylor, Stony Brook, Kentucky, Louisville

Garbage: Indiana, Galveston, San Antonio, LIJ, Nebraska, Oklahoma, Allegheny, Mayo-Jack, UC Irvine

I thought carbon was posting her list on ESPN on day 1 of the college football season.

 

[Music Man Stan]

Other places that I would steer good candidates away from are Utah, Loma Linda, Kaiser Permanente, City of Hope, Wake Forest and Arizona. Maybe not “hell pits” but these places have culture poor enough to result in residents leaving, poor oral board pass rates, or no experts in the field.

 

[Ray D. Ayshun]

Other places that I would steer good candidates away from are Utah, Loma Linda, Kaiser Permanente, City of Hope, Wake Forest and Arizona. Maybe not “hell pits” but these places have culture poor enough to result in residents leaving, poor oral board pass rates, or no experts in the field.

Utah has had something happen? The Jazz have enough high draft picks, it might be even more fun to be there in 4-5 years. Can jet over to CO for some gummies and shrooms.

 

[RickyScott]

Other places that I would steer good candidates away from are Utah, Loma Linda, Kaiser Permanente, City of Hope, Wake Forest and Arizona. Maybe not “hell pits” but these places have culture poor enough to result in residents leaving, poor oral board pass rates, or no experts in the field.

Will update. Pitt, Jeff, and maryland have good academics but nasty cultures as well. Heard that at wake, blackstock and greven take all the money and dump the work on everyone else, Poisining the department.

 

[deleted1116990]

I see this thread turning into a shίtshow pretty quickly...

 

[metallica81788]

Hey I interviewed at 7 of those places!

Oh wait...

 

[deleted1111261]

Trashing entire organizations based on half truths and gossip?? This is WHO WE ARE!

 

[RickyScott]

Trashing entire organizations based on half truths and gossip?? This is WHO WE ARE!

Are there any programs on the worst of the worst list that you believe reputable? It is constructive to identify hellpits for future closures.

 

[deleted1111261]

Are there any programs on the list that you think are reputable?

First of all, I think most programs overall are terrible and do not offer much teaching. We are moving in a direction where self-directed learning, e-resources, these types of sites, e-contour, etc. will provide much of the technical education.

I would say it would be better if every program cut rather than selecting "hellpits". Just as an example there is someone here that trashes the place that I trained at, makes up things and it becomes "truth". It's interesting that since the main person that teaches has left, the "ranking" has gone up. So, it seems someone just doesn't like someone else, and thus program is trash.

I don't care if MDACC is better than everyone else. We still don't need 7 + 2 from Baylor graduating from Houston every year. They did the right thing by going down a spot. Maybe one more next year???

My state - we have 11 graduates a year coming from Michigan programs. Why? Why does UMich have 3 spots when there are another 8 spots in the area? I sincerely don't care that they are "better" than DMC/Karmanos (are they really, though? karmanos grads that i've interacted with are fine). UMich should cut a spot. So should Karmanos. So should Beaumont.

Geography is not a reason to have or not have a program. WVU ain't training ROs for WV. Half the country seems to be training them for AZ, FL and TX. We can all live somewhere else for 4 years and then come back and practice where we are needed.

For those listed programs... I think they are fine. If someone is going to slap Utah on that list, that's fine, I guess - but I have never once heard that and have met quite a few well trained people from there. Some of this stuff comes off like some weird axe to grind. Maryland? Been tough place to train for years, but man they know what they are doing. Allegheny with Dr. Beriwal automatically makes it better than like 30 places.

Most of the people on this board that trained between 2005 and now could go to WVU and become a very competent RO. You're kidding yourself if you think the training varies that much. Y'all are so smart, you'd do fine anywhere.

 

[medgator]

Are there any programs on the worst of the worst list that you believe reputable? It is constructive to identify hellpits for future closures.

Upstate and Minnesota seemed fine for training, ditto for Rochester and Buffalo, just ****ty locations.

don't know enough about UC Davis either.

Edit: @RealSimulD nailed it

 

[Mandelin Rain]

Re: culture

I would have let attendings repeatedly kick me in the face if they were teaching me something while they did it. Unfortunately, indifference and complacency is much more common.

 

[RickyScott]

First of all, I think most programs overall are terrible and do not offer much teaching. We are moving in a direction where self-directed learning, e-resources, these types of sites, e-contour, etc. will provide much of the technical education.

I would say it would be better if every program cut rather than selecting "hellpits". Just as an example there is someone here that trashes the place that I trained at, makes up things and it becomes "truth". It's interesting that since the main person that teaches has left, the "ranking" has gone up. So, it seems someone just doesn't like someone else, and thus program is trash.

I don't care if MDACC is better than everyone else. We still don't need 7 + 2 from Baylor graduating from Houston every year. They did the right thing by going down a spot. Maybe one more next year???

My state - we have 11 graduates a year coming from Michigan programs. Why? Why does UMich have 3 spots when there are another 8 spots in the area? I sincerely don't care that they are "better" than DMC/Karmanos (are they really, though? karmanos grads that i've interacted with are fine). UMich should cut a spot. So should Karmanos. So should Beaumont.

Geography is not a reason to have or not have a program. WVU ain't training ROs for WV. Half the country seems to be training them for AZ, FL and TX. We can all live somewhere else for 4 years and then come back and practice where we are needed.

For those listed programs... I think they are fine. If someone is going to slap Utah on that list, that's fine, I guess - but I have never once heard that and have met quite a few well trained people from there. Some of this stuff comes off like some weird axe to grind. Maryland? Been tough place to train for years, but man they know what they are doing. Allegheny with Dr. Beriwal automatically makes it better than like 30 places.

Most of the people on this board that trained between 2005 and now could go to WVU and become a very competent RO. You're kidding yourself if you think the training varies that much. Y'all are so smart, you'd do fine anywhere.

I agree with much of this, but a us md with below average grades and tests just doesnt have to consider any of these places. They could easily still match at a fox chase, North Carolina, Wisconsin etc.

 

[thecarbonionangle]

I thought carbon was posting her list on ESPN on day 1 of the college football season.

It is absolutely coming. None of it will be surprising. Meet the 2023 hellpits, very similar to 2022. Voila!

The idea of avoiding closing bad programs vs just cut all evenly doesn’t make a lot of sense to me. These choices are not mutually exclusive. You can walk and chew gum. It doesn’t help the field when Anderson/CCF cuts spots while nearby hellpits continue “business as usual”. People can shill for them all they want but doesn’t make the pill easier to swallow.
The problem isn’t just that we have too many residents, it is also that we have too many programs with poor educational experiences. I wonder about agendas or the judgement of anyone who truly opposes closure of bad programs.

 

[deleted1116990]

First of all, I think most programs overall are terrible and do not offer much teaching.

I went to a middle of the road program and came out and was able to practice solo. I had gaps I quickly became aware of and had to teach myself a lot at first, but I felt comfortable enough and had the resources I needed to figure out how to treat most everything.

I've since learned that this is not always the case. I've talked with older colleagues who tell stories about new grads who have no idea what they are doing and freak out over basic contouring and plan approval, spend hours and hours on bread and butter plans, struggle with how to sim, etc.

It's messed up that many programs are dumping new grads in the market that require handholding by partners for many years. I studied for boards alone, but I have heard stories from others who went to Osler and were shocked at the minimal fund of knowledge attendees had, unable to verbalize how to treat an intact prostate and stuff like that. I consider myself lucky now.

 

[temujim]

First of all, I think most programs overall are terrible and do not offer much teaching. We are moving in a direction where self-directed learning, e-resources, these types of sites, e-contour, etc. will provide much of the technical education.

I would say it would be better if every program cut rather than selecting "hellpits". Just as an example there is someone here that trashes the place that I trained at, makes up things and it becomes "truth". It's interesting that since the main person that teaches has left, the "ranking" has gone up. So, it seems someone just doesn't like someone else, and thus program is trash.

I don't care if MDACC is better than everyone else. We still don't need 7 + 2 from Baylor graduating from Houston every year. They did the right thing by going down a spot. Maybe one more next year???

My state - we have 11 graduates a year coming from Michigan programs. Why? Why does UMich have 3 spots when there are another 8 spots in the area? I sincerely don't care that they are "better" than DMC/Karmanos (are they really, though? karmanos grads that i've interacted with are fine). UMich should cut a spot. So should Karmanos. So should Beaumont.

Geography is not a reason to have or not have a program. WVU ain't training ROs for WV. Half the country seems to be training them for AZ, FL and TX. We can all live somewhere else for 4 years and then come back and practice where we are needed.

For those listed programs... I think they are fine. If someone is going to slap Utah on that list, that's fine, I guess - but I have never once heard that and have met quite a few well trained people from there. Some of this stuff comes off like some weird axe to grind. Maryland? Been tough place to train for years, but man they know what they are doing. Allegheny with Dr. Beriwal automatically makes it better than like 30 places.

Most of the people on this board that trained between 2005 and now could go to WVU and become a very competent RO. You're kidding yourself if you think the training varies that much. Y'all are so smart, you'd do fine anywhere.

Cutting spots based on goodwill and collective action of the chairs/programs will never happen. Nice for MD Anderson and all that they cut one spot. But good luck telling, say Mississippi, to go from 1 spot to zero.

IMHO the only way to address the residency issue is to raise standards at the ACGME such that many programs would be forced to close. For example, a minimum resident complement of 8 (ie 2 a year), with a minimum clinical faculty ratio (by FTE!) of 2:1 AND a minimum clinical physics faculty ratio (instead of a minimum of 1... 1!). And the only way to change the ACGME is to take over the review committee with members who have such a goal.

 

[deleted1111261]

Cutting spots based on goodwill and collective action of the chairs/programs will never happen. Nice for MD Anderson and all that they cut one spot. But good luck telling, say Mississippi, to go from 1 spot to zero.

IMHO the only way to address the residency issue is to raise standards at the ACGME such that many programs would be forced to close. For example, a minimum resident complement of 8 (ie 2 a year), with a minimum clinical faculty ratio (by FTE!) of 2:1 AND a minimum clinical physics faculty ratio (instead of a minimum of 1... 1!). And the only way to change the ACGME is to take over the review committee with members who have such a goal.

Agree. And that’s what they tried.
Did you see the changes?
It may affect like 10-15 positions, if the programs don’t change.

I like the idea. It’s just the same people on committee are cozy with each other. Makes real change hard.

 

[RickyScott]

This thread can be a resource for applicants. We can quibble whether borderline places like suny upstate or uc Davis deserve hellpit status, but us MDs should still avoid them. (I think most of us would agree with the vast makority of programs on the list) Job market in 5 years will be brutal and us applicants really should be at a blue chip program. Top 25 programs will really struggle to fill with us MDs.

 

[thecarbonionangle]

This thread can be a resource for applicants. We can quibble whether borderline places like suny upstate or uc Davis deserve hellpit status, but us MDs should still avoid them. Job market in 5 years will be brutal and us applicants really should be at a blue chip program. Top 25 programs will really struggle to fill with us MDs.

There will never be absolutely universal agreements on places. There might be some collateral damage. Some might prefer to cut the baby in half (king solomon) while some prefer to use common sense to get rid of generally/reasonably bad places. Sorry but some feelings will be hurt.

 

[RickyScott]

I took Minnesota and allegenehy off the list. I didn’t know beriwal left pitt

 

[Ray D. Ayshun]

I went to a middle of the road program and came out and was able to practice solo. I had gaps I quickly became aware of and had to teach myself a lot at first, but I felt comfortable enough and had the resources I needed to figure out how to treat most everything.

I've since learned that this is not always the case. I've talked with older colleagues who tell stories about new grads who have no idea what they are doing and freak out over basic contouring and plan approval, spend hours and hours on bread and butter plans, struggle with how to sim, etc.

It's messed up that many programs are dumping new grads in the market that require handholding by partners for many years. I studied for boards alone, but I have heard stories from others who went to Osler and were shocked at the minimal fund of knowledge attendees had, unable to verbalize how to treat an intact prostate and stuff like that. I consider myself lucky now.

Based on how I scored on the oral boards last year, there must be a lot of newer radoncs who can barely tie their shoes.

 

[temujim]

Agree. And that’s what they tried.
Did you see the changes?
It may affect like 10-15 positions, if the programs don’t change.

I like the idea. It’s just the same people on committee are cozy with each other. Makes real change hard.

Honestly don't know how one gets on the ACGME residency review committee. But is the change going to happen with the current complement?

Review Committee Members
ACGME RC Members listed below are active between July 1, 2022 and June 30, 2023.
Michael L. Steinberg, MD, FASTRO, FACR Chair
Prajnan Das, MD, MS, MPH, FACR Vice Chair
May Elbanna, MD; Resident Member
Janice Lynn Kishner, RN, MSN, MBA, FACHE; Public Member
Ronald Chen, MD, MPH
Brian J. Davis, MD, PhD
Louis Potters, MD FACR, FASTRO, FABS
Srinivasan Vijayakumar, MD, DMRT, DABR, FACR

 

[thecarbonionangle]

Honestly don't know how one gets on the ACGME residency review committee. But is the change going to happen with the current complement?

Review Committee Members
ACGME RC Members listed below are active between July 1, 2022 and June 30, 2023.
Michael L. Steinberg, MD, FASTRO, FACR Chair
Prajnan Das, MD, MS, MPH, FACR Vice Chair
May Elbanna, MD; Resident Member
Janice Lynn Kishner, RN, MSN, MBA, FACHE; Public Member
Ronald Chen, MD, MPH
Brian J. Davis, MD, PhD
Louis Potters, MD FACR, FASTRO, FABS
Srinivasan Vijayakumar, MD, DMRT, DABR, FACR

Some of these folk have great COI. Will they cut off their foot?

 

[RickyScott]

Some of these folk have great COL. Will they cut off their foot?

Last I checked mike steinberg was making 1 mill and lou potters 1.8 in 2019. Have their salaries increased?

 

[thecarbonionangle]

Sorry typo meant COI. Im sure they have great QOL. My pt is how do you expect these guys to cut their own programs. If all programs are “fine” then nothing should be cut. No issues. Follow this thinking to logical conclusion and nothing is done .Utter nonsense. ACGME reforms are super watered down, “piss in the right direction”. We are screwed I guess. Time to hit the bubbly rosé with ma gurls/pals. Cheers!

 

[RickyScott]

Sorry typo meant COI. Im sure they have great QOL. My pt is how do you expect these guys to cut their own programs. If all programs are “fine” then nothing should be cut. No issues. Follow this thinking to logical conclusion and nothing is done .Utter nonsense. ACGME reforms are super watered down, “piss in the right direction”. We are screwed I guess. Time to hit the bubbly rosé with ma gurls/pals. Cheers!

Funny how Louis potters is on both scarop and acgme review committee. Same people all over astro and these committees

 

[Vandalia]

FWIW, as an outsider to this specialty, WVU Radiation Oncology lists only 2 residents total, both in PGY 4-5.

Make of that what you will.

WVU Radiation Oncology Current Residents

 

[RickyScott]

FWIW, as an outsider to this specialty, WVU Radiation Oncology lists only 2 residents total, both in PGY 4-5.

Make of that what you will.

WVU Radiation Oncology Current Residents

May have transferred to a slightly better program. Heard that a Columbia resident left for another hellpit that wasn’t quite as bad a few years ago.

 

[RickyScott]

Honestly don't know how one gets on the ACGME residency review committee. But is the change going to happen with the current complement?

Review Committee Members
ACGME RC Members listed below are active between July 1, 2022 and June 30, 2023.
Michael L. Steinberg, MD, FASTRO, FACR Chair
Prajnan Das, MD, MS, MPH, FACR Vice Chair
May Elbanna, MD; Resident Member
Janice Lynn Kishner, RN, MSN, MBA, FACHE; Public Member
Ronald Chen, MD, MPH
Brian J. Davis, MD, PhD
Louis Potters, MD FACR, FASTRO, FABS
Srinivasan Vijayakumar, MD, DMRT, DABR, FACR

Srinivasan Vijayakumar- chairman of university of Mississippi a flaming pit of sh-t. They only take fmgs following several years of indentured fellowShips at Mississippi prior to residency!

 

[elementaryschooleconomics]

MEANWHILE, ON TWITTER:

When I see these threads on SDN, or Tweets like...whatever it is Sloan is doing here, I immediately think about how many people jump on Optune with "THERE WAS NO SHAM CONTROL ARM", then turn around and willingly offer these strong opinions.

Unless you personally did multiple residencies, how can you say your program was "the best" or "the worst"?

I don't mean to pick a side in a "hellpit" thread, though doing so is a yearly SDN RadOnc tradition. I just honestly don't know how to interpret this stuff anymore.

If I exclusively reflect on my own experience in my own program, and talk to current residents as well as alumni going back to 2012ish, there definitely seems to be distinct "eras" of training. I was (and am) painfully aware of the issues that were happening in my training cohort. Talking to alumni from the 2012-2016 era, they seemed to have a more positive experience than my friends and I. But it's very clear, in talking to the current residents, that after I graduated there was interesting (and rapid) faculty/staff turnover, and the stories I hear make the place sound foreign. I don't know if the changes have made it better or worse, I only know that the department has a workflow and culture that I didn't experience.

I'm certainly not playing the "middle-of-the-road" card, saying "both sides have merit". There are definitely places with structural/systems-level policies that are more permanent, both good and bad.

But, I totally agree with @RealSimulD. In 2022 and beyond, there are incredible resources anyone can access, and learning to be a good Radiation Oncologist has been democratized. So while I can't name specific "hellpit" programs, I can confidently state the only advice I'd give to someone who wants to roll the dice on RadOnc:

You need to pick a program based on the reputation of the institution among the patient population. Don't try to go to Harvard because "the training is good" or whatever BS you write in your personal statement, you should try to go to Harvard because the majority of your patients will be average Americans from average areas of the country, and most average Americans will know the Harvard name and be impressed. Fortunately, "name brand" programs also have big alumni networks to help with jobs.

So, to yank the wheel hard on an SDN Tradition: if a program isn't "name brand", it's a hellpit.

If you want a job, you better not be buying Kirkland Sparkling Wine.

You want Ace of Spades.

 

[resident#]

Speaking of the ACGME, med studs should be aware that they can look up accreditation issues on the acgme website.
Summary here:
Continuing accredition with warning: Harvard, Georgetown, Rush, Rutgers, UC Irvine, Kentucky
Probationary accredition: MUSC
Initial accredition with warning: West Virginia

 

[temujim]

Speaking of the ACGME, med studs should be aware that they can look up accreditation issues on the acgme website.
Summary here:
Continuing accredition with warning: Harvard, Georgetown, Rush, Rutgers, UC Irvine, Kentucky
Probationary accredition: MUSC
Initial accredition with warning: West Virginia

Initial accredition with warning: West Virginia

WTF?

 

[deleted1111261]

Initial accredition with warning: West Virginia

WTF?

Seriously

Also I think Harvard always on probation

 

[RickyScott]

MEANWHILE, ON TWITTER:

View attachment 358885

When I see these threads on SDN, or Tweets like...whatever it is Sloan is doing here, I immediately think about how many people jump on Optune with "THERE WAS NO SHAM CONTROL ARM", then turn around and willingly offer these strong opinions.

Unless you personally did multiple residencies, how can you say your program was "the best" or "the worst"?

I don't mean to pick a side in a "hellpit" thread, though doing so is a yearly SDN RadOnc tradition. I just honestly don't know how to interpret this stuff anymore.

If I exclusively reflect on my own experience in my own program, and talk to current residents as well as alumni going back to 2012ish, there definitely seems to be distinct "eras" of training. I was (and am) painfully aware of the issues that were happening in my training cohort. Talking to alumni from the 2012-2016 era, they seemed to have a more positive experience than my friends and I. But it's very clear, in talking to the current residents, that after I graduated there was interesting (and rapid) faculty/staff turnover, and the stories I hear make the place sound foreign. I don't know if the changes have made it better or worse, I only know that the department has a workflow and culture that I didn't experience.

I'm certainly not playing the "middle-of-the-road" card, saying "both sides have merit". There are definitely places with structural/systems-level policies that are more permanent, both good and bad.

But, I totally agree with @RealSimulD. In 2022 and beyond, there are incredible resources anyone can access, and learning to be a good Radiation Oncologist has been democratized. So while I can't name specific "hellpit" programs, I can confidently state the only advice I'd give to someone who wants to roll the dice on RadOnc:

You need to pick a program based on the reputation of the institution among the patient population. Don't try to go to Harvard because "the training is good" or whatever BS you write in your personal statement, you should try to go to Harvard because the majority of your patients will be average Americans from average areas of the country, and most average Americans will know the Harvard name and be impressed. Fortunately, "name brand" programs also have big alumni networks to help with jobs.

So, to yank the wheel hard on an SDN Tradition: if a program isn't "name brand", it's a hellpit.

If you want a job, you better not be buying Kirkland Sparkling Wine.

You want Ace of Spades.

View attachment 358886

I trained at horrible program, but I don’t for a minute feel disadvantaged given all the online and other resources. In todays climate, however, to choose such a program reflects poor judgement when top places are open to just about everybody.

 

[salubalu]

Pits of Hell: with match 2023 round the corner, we should revisit the absolute worst programs in radiation oncology. Grads should not expect employment. There is just no legitimate reason for a us md to apply.

Worst of the worst. Us MDs should not attend under any circumstances: West Virgina, Arkansas, Mississippi, MCSC, Tennessee, Baylor Scott and White, Dartmouth, Columbia, SUNY downstate, SUNY upstate, Brooklynn Methodist, Baylor, Stony Brook, Kentucky, Louisville

Garbage: Indiana, Galveston, San Antonio, LIJ, Nebraska, Oklahoma, Mayo-Jack, UC Irvine,

Some of you guys are quick to call out these programs. I am a graduate from one of these worst of the worst programs. Myself and all of my colleagues who have graduated were fortunate to get great community practice jobs where we all make over 500k+ starting salaries. One is now leading a center. I myself in residency never recruited a single patient on a radiation trial and in community practice have opened several trials and our center is a top 3 national recruiter on NRG prostate trials. We were all relatively personable individuals with a strong work ethic. Paint brushing entire programs and their graduates has a lot of problems. We’re all happy in our first jobs and all 3-5 years into our practices. I remember during a rotation at a top 3 center a nurse called me out as being less qualified because I’m a DO. People will always try to shoot others down.

Work hard, do honest work, and find contentment in life.

 

[deleted1111261]

Some of you guys are quick to call out these programs. I am a graduate from one of these worst of the worst programs. Myself and all of my colleagues who have graduated were fortunate to get great community practice jobs where we all make over 500k+ starting salaries. One is now leading a center. I myself in residency never recruited a single patient on a radiation trial and in community practice have opened several trials and our center is a top 3 national recruiter on NRG prostate trials. We were all relatively personable individuals with a strong work ethic. Paint brushing entire programs and their graduates has a lot of problems. We’re all happy in our first jobs and all 3-5 years into our practices. I remember during a rotation at a top 3 center a nurse called me out as being less qualified because I’m a DO. People will always try to shoot others down.

Work hard, do honest work, and find contentment in life.

Fantastic post

 

[ROforbetterorworse]

Some of you guys are quick to call out these programs. I am a graduate from one of these worst of the worst programs. Myself and all of my colleagues who have graduated were fortunate to get great community practice jobs where we all make over 500k+ starting salaries. One is now leading a center. I myself in residency never recruited a single patient on a radiation trial and in community practice have opened several trials and our center is a top 3 national recruiter on NRG prostate trials. We were all relatively personable individuals with a strong work ethic. Paint brushing entire programs and their graduates has a lot of problems. We’re all happy in our first jobs and all 3-5 years into our practices. I remember during a rotation at a top 3 center a nurse called me out as being less qualified because I’m a DO. People will always try to shoot others down.

Work hard, do honest work, and find contentment in life.

So many uber talented self motivated folks matched in rad onc past 15 years which masked terrible training mentors

Now times have changed with applicant pool so important to know what is a terrible program

 

[yesmaster]

Obviously a topic that arouses strong emotions.
- You had a horrible experience at your hellpit residency program and you’d like to spare future trainees from that suffering
- You feel personally attacked if you graduated from or currently work at a hellpit
- You feel personally attacked if you graduated from or currently work at a MDA/MSKCC/Penn if people say your program provides equivalent training to a hellpit

Is this person a good radiation oncologist?

Personally, I feel like there’s a lot of variation within individual programs, and there’s so many factors that go into this, that pedigree is not a good biomarker for whether someone will be a good colleague/partner.

I’ve worked with fantastic rad onc’s from top 10 programs and fantastic rad onc’s from hellpit programs. A lot of what matters is whether someone is easy to work with and communicate with, whether someone continues to learn during independent practice, and whether someone practices in a conscientious manner.

Is this a good residency program for me to train to be a radiation oncologist?

That being said, it’s obvious to me that some programs provide superior clinical training to others.

It takes more effort to become a good radiation oncologist at a hellpit program, and it’s a substantially more painful process.

Culture is very key and underrated. Geographic location is also very key. Lab mice learn slowly under stressed conditions. So it goes with lab mice in rad onc residencies.

Does the idea of hellpit programs (“name and shame”) help to combat residency over-expansion and over-training?

Maybe no, maybe yes.

I agree that it’s very easy as Department Chair or rad onc leadership to blame other programs. “They” should close their program or cut spots. “We” are an outstanding program, if anything we should add spots!

The problem is that this sort of thinking is rampant even at hellpit programs, imagine that. “Those other hellpit programs should cut spots, we provide outstanding hands-on training for vulnerable populations in a geographically underserved area, residents are a critical part of our clinical workforce, we can’t cut spots.”

Everyone should cut spots.

A smart, motivated student at a hellpit program will probably become a decent radiation oncologist. A student who struggled in medical school, who failed to match to psychiatry or anesthesia, will probably struggle to become a decent radiation oncologist.

From a utilitarian point of view, fewer qualified, employable rad oncs will join the workforce if good trainees go to good programs and bad programs don’t fill, SOAP ugh, or fill with not-as-good trainees. Sadly, that’s a good thing these days in rad onc.

 

[Music Man Stan]

First of all, I think most programs overall are terrible and do not offer much teaching. We are moving in a direction where self-directed learning, e-resources, these types of sites, e-contour, etc. will provide much of the technical education.

I would say it would be better if every program cut rather than selecting "hellpits". Just as an example there is someone here that trashes the place that I trained at, makes up things and it becomes "truth". It's interesting that since the main person that teaches has left, the "ranking" has gone up. So, it seems someone just doesn't like someone else, and thus program is trash.

I don't care if MDACC is better than everyone else. We still don't need 7 + 2 from Baylor graduating from Houston every year. They did the right thing by going down a spot. Maybe one more next year???

My state - we have 11 graduates a year coming from Michigan programs. Why? Why does UMich have 3 spots when there are another 8 spots in the area? I sincerely don't care that they are "better" than DMC/Karmanos (are they really, though? karmanos grads that i've interacted with are fine). UMich should cut a spot. So should Karmanos. So should Beaumont.

Geography is not a reason to have or not have a program. WVU ain't training ROs for WV. Half the country seems to be training them for AZ, FL and TX. We can all live somewhere else for 4 years and then come back and practice where we are needed.

For those listed programs... I think they are fine. If someone is going to slap Utah on that list, that's fine, I guess - but I have never once heard that and have met quite a few well trained people from there. Some of this stuff comes off like some weird axe to grind. Maryland? Been tough place to train for years, but man they know what they are doing. Allegheny with Dr. Beriwal automatically makes it better than like 30 places.

Most of the people on this board that trained between 2005 and now could go to WVU and become a very competent RO. You're kidding yourself if you think the training varies that much. Y'all are so smart, you'd do fine anywhere.

Utah has had multiple residents actually leave and others attempt to leave because of their culture. I think Thomas Jefferson may have a similar problem as well but I don’t know the specifics.

 

[RickyScott]

A radiation oncologist is 99% the individual and 1% the program, but we still need criteria for cutting slots so let’s close the bad programs. I trained at a hellpit and don’t take it personally. Good location and that the program was not malignant at all. There was almost zero teaching and most of what they said was wrong anyway. They also didn’t give a rats a— if you even showed up. But, jobs were plentiful at the time, and it didnt hold me back.

I am arrogant re my competency. I honestly feel I am better than the vast majority of radoncs and if I needed xrt, I would treat myself.

Jeff rychman at West Virginia is an outstanding physician, particularly when it comes to planning. Anyone training under him would be in great hands. And if that person was a do/fmg I could understand. However, there is just no good reason a us md should be at WV given how tight the job market has become. (In my day, someone like Jeff would be at a top 3 program) Even case western, which is not truly a hellpit- is matching carribean grads who seem like total tools on twitter.

 

[thecarbonionangle]

A radiation oncologist is 99% the individual and 1% the program, but we still need criteria for cutting slots so let’s close the bad programs. I trained at a hellpit and don’t take it personally. Good location and that the program was not malignant at all. There was almost zero teaching and most of what they said was wrong anyway. They also didn’t give a rats a— if you even showed up. But, jobs were plentiful at the time, and it didnt hold me back.

I am arrogant re my competency. I honestly feel I am better than the vast majority of radoncs and if I needed xrt, I would treat myself.

Jeff rychman at West Virginia is an outstanding physician, particularly when it comes to planning. Anyone training under him would be in great hands. And if that person was a do/fmg I could understand. However, there is just no good reason a us md should be at WV given how tight the job market has become. (In my day, someone like Jeff would be at a top 3 program) Even case western, which is not truly a hellpit- is matching carribean grads who seem like total tools on twitter.

Be careful brotha, you making too much sense. The all programs are “fine” crowd might get their feelings hurt, and they might accuse you of “trying to bring people down”. This issue will never be fixed. I am very comfortable with this putrid swamp. It is here to stay. The field is absolutely done and even people trying to “fix” things are bringing a spoon to a gun fight.

 

[medgator]

Jeff rychman at West Virginia is an outstanding physician, particularly when it comes to planning. Anyone training under him would be in great hands. And if that person was a do/fmg I could understand. However, there is just no good reason a us md should be at WV given how tight the job market has become. (In my day, someone like Jeff would be at a top 3 program) Even case western, which is not truly a hellpit- is matching carribean grads who seem like total tools on twitter.

Does Jeff even work at main campus or that ****ty WVU satellite that got posted to ASTRO the last few years? If satellite, residents will likely get very little time with him and more with the boomer chair helping to wreck the field

 

[temujim]

Does Jeff even work at main campus or that ****ty WVU satellite that got posted to ASTRO the last few years? If satellite, residents will likely get very little time with him and more with the boomer chair helping to wreck the field

Boomer chair out. Super young guy in. Good luck to him. But still no reason for WVU to have a residency.

 

[deleted1111261]

Boomer chair out. Super young guy in. Good luck to him. But still no reason for WVU to have a residency.

He’s not that young

 

[deleted1111261]

Should let Jeff can speak for himself, but I don’t think he’s there due to tight job market.

 

[RickyScott]

Can anyone confirm that Mississippi takes qualified radoncs from India, forces them to do a fellowship for a few years and then offers them a residency spot?

 

[thecarbonionangle]

Can anyone confirm that Mississippi takes qualified radoncs from India, forces them to do a fellowship for a few years and then offers them a residency spot?

I dont think they “force” them, but they do have a pathway to do the fellowship then stay on as residents. They have taken indian FMGs. Recent grad Toms is a smart hard working guy. I have heard VJ chair is a great guy. The point is not that their grads are incompetent, they are absolutely not, it simply is that they should not have a program…. If we cannot agree on the basic premises, we cannot fix this issue. This is why i am very bearish on it. I think the problem is here to stay. Why would the MS chair agree to tighten the ACGME requirements to close his own program? Why would WVU chair ASTRO president lead on this issue? Some are just pie in sky folks. I ain’t about that life, ain’t anybody got time for that!

 

[deleted1111261]

The premise that just “hellpit” programs as named should all close - how do you make that happen?

More existing programs grew then new programs opened up. Everyone is culpable.

There is truly know way to fix this unless PDs collude and make a decision nationally without coercion. Never will happen, until it is marginally more profitable to not have residents.

 

[RickyScott]

I dont think they “force” them, but they do have a pathway to do the fellowship then stay on as residents. They have taken indian FMGs. Recent grad Toms is a smart hard working guy. I have heard VJ chair is a great guy. The point is not that their grads are incompetent, they are absolutely not, it simply is that they should not have a program…. If we cannot agree on the basic premises, we cannot fix this issue. This is why i am very bearish on it. I think the problem is here to stay. Why would the MS chair agree to tighten the ACGME requirements to close his own program? Why would WVU chair ASTRO president lead on this issue? Some are just pie in sky folks. I ain’t about that life, ain’t anybody got time for that!

In residency, we had a fully trained guy from India (better than the attendings) who ran a service with 0 oversight from the chair, and the chair pocketed all the professional fees after signing off on everything. Eventually, he was given a residency slot after about 3 years.

 

[fiji128]

The premise that just “hellpit” programs as named should all close - how do you make that happen?

More existing programs grew then new programs opened up. Everyone is culpable.

There is truly know way to fix this unless PDs collude and make a decision nationally without coercion. Never will happen, until it is marginally more profitable to not have residents.

“Easiest” way would be to increase brachytherapy requirements to the point where graduates would be technically competent in most brachy procedures. This will not happen for obvious reasons.