Now that a new year is upon us, let us take a moment to remember those we have lost in the last year. I ran across this tribute to our old friend radiation oncology.
Radiation Oncology, the formerly competitive and inspiring specialty, died in late 2019, the American Board of Radiology announced.
The once prominent specialty struggled in recent years to attract talent. At the end of 2019 it was clear that the end was eminent. Hospice was initiated. The pearly gates opened, and Radiation Oncology reunited with its old friend nuclear medicine.
Radiation oncology was born in the late 1960s to the American Board of Radiology. The early years were quite a struggle for the specialty. The only prerequisite for admission was a pulse. “We used to have so much free time we convinced ourselves that radiation biology was useful” quipped Paul Wallner, one of the first radiation oncologists. “We continued this time-wasting charade until 2018 when residents started to understand the uselessness.”
Over time the specialty grew. Residents that spoke some English and were on the spectrum began to matriculate in the mid to late 1990s.
The heyday began in the early 2000s with the advent and growth of IMRT. The fossilized founders of the field were kicking and screaming. “You mean to tell me I have to know the tumor’s location and draw it on this computer? I’ll just keep 100% resident staffing for attendings in perpetuity instead” Ralph Weichselbaum, one of the oldest fossils in medicine, was quoted as saying at the time.
Reimbursement increased significantly and lagging not too far behind was competitiveness of the specialty. Nearly two decades of highly qualified residents followed the reimbursement increase.
Academic radiation oncologists became jealous of their ever-richer private practice friends. They went to their chairs and threatened to only remain in academia with 100% support with a highly qualified nurse practitioner. A “resident” as they called them.
Over time the academic attending’s skills died faster than radiation for lymphoma. Fortunately, Chairs protected the fossils. While the resident was doing all the work, the fossils did research to show that radiation was unnecessary. They spent the remainder of their careers advocating for omission of radiation.
Cracks began to form in 2013 when a brave resident published that physician supply may outstrip radiation demand. He made such controversial statements as “If demand decreases and supply increases the job market may be impacted” he continued his verbal assault by saying “maybe we should look into this”
The consternation was quick and harsh. “We knew he was right, but we had to pretend like everything was great. I couldn’t have attendings contouring and writing notes” said Dennis Hallahan, his former chair at Washington University. “Instead I just blackballed his a** and had the fossils play along. That probably ended up buying us about 5 more years where we could expand the residency cohort into oblivion.”
“I knew ASTRO was going to sit on their hands because I paid Ben Falit to tell them the Feds would do a raid if they advocated for their constituents job prospects.” Hallahan chuckled. “I knew they were gullible, but I didn’t know they were that gullible…hahahahah”
Over time residents caught on to their limited job prospects. It remained quiet until 2018.
“That’s when all hell broke loose” said Lisa Kachnic. “These kids didn’t know their radiation biology and Paul Wallner was mad about it. We wrote an editorial calling residents stupid. Then we failed half of them on their boards.” Lisa was becoming increasingly agitated during the interview.
“Back in my day you just kept your head down and bowed to the fossils. I said prayers to a shrine of Luther Brady. Now these residents have the gall to ask questions.” Kachnic continued her diatribe. “They even criticized me online. The millennial's call that cyberbullying. I mean, I know we failed them all, but I was the victim of some tough questions. They made me explain myself.”
Lisa Kachnic became too upset to continue the interview. When her term ended with the ABR she started a cyberbullying support group for baby boomers.
After failing worthless boards, the residents realized their colossal mistake. They went through 5 years of training in a dying specialty only to be called stupid for not knowing protein MDE876ER56821.
Attendings and residents alike gathered on an underground, dark web forum called Student Doctor.
“I tried for two hours to access it but couldn’t quite get there. I was hooking up my phone cord, blowing on it, checking for a dial tone, calling tech support, powering down power up. I even went on my roof to make sure there wasn’t any fresh Minnesota snow on my satellite dish. The neighborhood kids that won’t get off my lawn thought I was Santa. After all that I still couldn’t get dialed into Student Doctor. Instead I dialed up twitter and called them malcontents” said Ken Olivier who is one of the newest radiation oncology fossils.
When Olivier was told everyone can access and post on Student Doctor, he paused in disbelief.
“They don’t have real doctors there. How am I supposed to black ball the career of someone named ‘medgator’? I can’t find medgator’s healthgrades page. Is medgator their first name or last name? If I see them on twitter, I could personally attack them for having opinions.”
In the interim jobs continued to decline, and residents continued to complain. They started publishing papers about their concerns.
“As soon as I read that paper, I knew I had to act” said Louis Potters. “We just recently opened a program and I knew we would get criticism if residents had concerns about the job market. I pulled out my typewriter and pecked away. The first thing I came up with was “concerns”. It was ingenious. I PUT IT IN QUOTES!!! HAHAHAHAH” he exclaimed while slapping his knee.
Since his department now has resident slave labor, Potters had his resident transcribe his scroll into electronic form for journal submission. “When I was a resident, we had chalk and X-ray film. Now that I have residents, I have reverted to typewriters and stone tablets. It’s like the good ole days when residents didn’t speak unless spoken to.”
The divide between academics and everyone else increased. Some wise academics removed their heads from the hind quarters of Simon Powell. “It was quite refreshing to listen to different points of view” said Rahul Tendulkar. “I realized other people can also make points.”
This was controversial.
When we asked Paul Wallner if people under the age of 70 can have opinions he said “Lisa Kachnic and I are brainstorming and drafting a manuscript on this very topic. Since it is not yet published, I cannot divulge many details. The title will be ‘Not Only No, but Hell to The No’. The millennials like saying ‘hell to the no’, I’m not sure what it means.”
Wallner was clearly trying to placate the millennials with the title. He was still distraught after his google search of “Ok boomer” only showed pictures of himself counting money that he received from the fraudulent billing practices at 21st century oncology. “Only the government thought it was fraud, the ABR saw it as a resume building experience to qualify me to fail residents on their boards.”
As controversy increased and jobs decreased, medical students stopped applying to radiation oncology. “Why would I waste all this training to be lucky to get a job practicing on the Frontier” said one medical student.
“Neha Vapiwala thought she was helping the field when she said there were plenty of jobs in Cambodia and on the Frontier” the medical student continued referring to a recent article on alternative careers for unemployed radiation oncologists. “I couldn’t help but think to myself, ‘Why in the f**k would I want to have to be lucky to practice on a Frontier’?”.
“When Neha Vapiwala packs her Conestoga wagon and heads out West maybe I can take her job.” The medical student went on to say medical oncologists can practice in the same country in which they train. There are no publications in JAMA oncology talking about helping Russian physicians learn about chemotherapy as a career.
The final nail was bundled payments and a change in the supervision requirements. Private practices stopped hiring. When they needed more physicians, they offered “fellowships.”
The last qualified radiation oncology residents will finish up and head to the Dakotas or Cambodia if they’re lucky. The rest will leave medicine to make room for reentry of non-English speaking foreign medical graduates on the spectrum seeking visa sponsorship opportunities.
Ralph Weichselbaum was at the funeral but did not show remorse. “Residents can go be pediatricians. In the meantime, I’m going to keep terrorizing University of Chicago residents until they come with a body bag and wheel barrel into my office.”
ASTRO was also present for the funeral but declined to comment because they think they are under surveillance by the anti-trust division of the feds. “We can’t comment on radiation oncology’s death. We aren’t allowed to advocate for the specialty” they whispered under their breath.
Lisa Kachnic gave the euology. She blamed small programs for the demise of the specialty. She said the data to back up her claim is still maturing. She was confident she was right this time as opposed to the last time she claimed small programs did worse on board exams. That statement led to a forced retraction one year later. “I still make no apologizes for the ABR board fiasco and I am the victim of cyberbullying so f**k off” were her final departing words to radiation oncology.
In lieu of flowers, donations may be made to the debt of current residents. Cambodia does not pay as well as we had hoped.
Radiation Oncology, the formerly competitive and inspiring specialty, died in late 2019, the American Board of Radiology announced.
The once prominent specialty struggled in recent years to attract talent. At the end of 2019 it was clear that the end was eminent. Hospice was initiated. The pearly gates opened, and Radiation Oncology reunited with its old friend nuclear medicine.
Radiation oncology was born in the late 1960s to the American Board of Radiology. The early years were quite a struggle for the specialty. The only prerequisite for admission was a pulse. “We used to have so much free time we convinced ourselves that radiation biology was useful” quipped Paul Wallner, one of the first radiation oncologists. “We continued this time-wasting charade until 2018 when residents started to understand the uselessness.”
Over time the specialty grew. Residents that spoke some English and were on the spectrum began to matriculate in the mid to late 1990s.
The heyday began in the early 2000s with the advent and growth of IMRT. The fossilized founders of the field were kicking and screaming. “You mean to tell me I have to know the tumor’s location and draw it on this computer? I’ll just keep 100% resident staffing for attendings in perpetuity instead” Ralph Weichselbaum, one of the oldest fossils in medicine, was quoted as saying at the time.
Reimbursement increased significantly and lagging not too far behind was competitiveness of the specialty. Nearly two decades of highly qualified residents followed the reimbursement increase.
Academic radiation oncologists became jealous of their ever-richer private practice friends. They went to their chairs and threatened to only remain in academia with 100% support with a highly qualified nurse practitioner. A “resident” as they called them.
Over time the academic attending’s skills died faster than radiation for lymphoma. Fortunately, Chairs protected the fossils. While the resident was doing all the work, the fossils did research to show that radiation was unnecessary. They spent the remainder of their careers advocating for omission of radiation.
Cracks began to form in 2013 when a brave resident published that physician supply may outstrip radiation demand. He made such controversial statements as “If demand decreases and supply increases the job market may be impacted” he continued his verbal assault by saying “maybe we should look into this”
The consternation was quick and harsh. “We knew he was right, but we had to pretend like everything was great. I couldn’t have attendings contouring and writing notes” said Dennis Hallahan, his former chair at Washington University. “Instead I just blackballed his a** and had the fossils play along. That probably ended up buying us about 5 more years where we could expand the residency cohort into oblivion.”
“I knew ASTRO was going to sit on their hands because I paid Ben Falit to tell them the Feds would do a raid if they advocated for their constituents job prospects.” Hallahan chuckled. “I knew they were gullible, but I didn’t know they were that gullible…hahahahah”
Over time residents caught on to their limited job prospects. It remained quiet until 2018.
“That’s when all hell broke loose” said Lisa Kachnic. “These kids didn’t know their radiation biology and Paul Wallner was mad about it. We wrote an editorial calling residents stupid. Then we failed half of them on their boards.” Lisa was becoming increasingly agitated during the interview.
“Back in my day you just kept your head down and bowed to the fossils. I said prayers to a shrine of Luther Brady. Now these residents have the gall to ask questions.” Kachnic continued her diatribe. “They even criticized me online. The millennial's call that cyberbullying. I mean, I know we failed them all, but I was the victim of some tough questions. They made me explain myself.”
Lisa Kachnic became too upset to continue the interview. When her term ended with the ABR she started a cyberbullying support group for baby boomers.
After failing worthless boards, the residents realized their colossal mistake. They went through 5 years of training in a dying specialty only to be called stupid for not knowing protein MDE876ER56821.
Attendings and residents alike gathered on an underground, dark web forum called Student Doctor.
“I tried for two hours to access it but couldn’t quite get there. I was hooking up my phone cord, blowing on it, checking for a dial tone, calling tech support, powering down power up. I even went on my roof to make sure there wasn’t any fresh Minnesota snow on my satellite dish. The neighborhood kids that won’t get off my lawn thought I was Santa. After all that I still couldn’t get dialed into Student Doctor. Instead I dialed up twitter and called them malcontents” said Ken Olivier who is one of the newest radiation oncology fossils.
When Olivier was told everyone can access and post on Student Doctor, he paused in disbelief.
“They don’t have real doctors there. How am I supposed to black ball the career of someone named ‘medgator’? I can’t find medgator’s healthgrades page. Is medgator their first name or last name? If I see them on twitter, I could personally attack them for having opinions.”
In the interim jobs continued to decline, and residents continued to complain. They started publishing papers about their concerns.
“As soon as I read that paper, I knew I had to act” said Louis Potters. “We just recently opened a program and I knew we would get criticism if residents had concerns about the job market. I pulled out my typewriter and pecked away. The first thing I came up with was “concerns”. It was ingenious. I PUT IT IN QUOTES!!! HAHAHAHAH” he exclaimed while slapping his knee.
Since his department now has resident slave labor, Potters had his resident transcribe his scroll into electronic form for journal submission. “When I was a resident, we had chalk and X-ray film. Now that I have residents, I have reverted to typewriters and stone tablets. It’s like the good ole days when residents didn’t speak unless spoken to.”
The divide between academics and everyone else increased. Some wise academics removed their heads from the hind quarters of Simon Powell. “It was quite refreshing to listen to different points of view” said Rahul Tendulkar. “I realized other people can also make points.”
This was controversial.
When we asked Paul Wallner if people under the age of 70 can have opinions he said “Lisa Kachnic and I are brainstorming and drafting a manuscript on this very topic. Since it is not yet published, I cannot divulge many details. The title will be ‘Not Only No, but Hell to The No’. The millennials like saying ‘hell to the no’, I’m not sure what it means.”
Wallner was clearly trying to placate the millennials with the title. He was still distraught after his google search of “Ok boomer” only showed pictures of himself counting money that he received from the fraudulent billing practices at 21st century oncology. “Only the government thought it was fraud, the ABR saw it as a resume building experience to qualify me to fail residents on their boards.”
As controversy increased and jobs decreased, medical students stopped applying to radiation oncology. “Why would I waste all this training to be lucky to get a job practicing on the Frontier” said one medical student.
“Neha Vapiwala thought she was helping the field when she said there were plenty of jobs in Cambodia and on the Frontier” the medical student continued referring to a recent article on alternative careers for unemployed radiation oncologists. “I couldn’t help but think to myself, ‘Why in the f**k would I want to have to be lucky to practice on a Frontier’?”.
“When Neha Vapiwala packs her Conestoga wagon and heads out West maybe I can take her job.” The medical student went on to say medical oncologists can practice in the same country in which they train. There are no publications in JAMA oncology talking about helping Russian physicians learn about chemotherapy as a career.
The final nail was bundled payments and a change in the supervision requirements. Private practices stopped hiring. When they needed more physicians, they offered “fellowships.”
The last qualified radiation oncology residents will finish up and head to the Dakotas or Cambodia if they’re lucky. The rest will leave medicine to make room for reentry of non-English speaking foreign medical graduates on the spectrum seeking visa sponsorship opportunities.
Ralph Weichselbaum was at the funeral but did not show remorse. “Residents can go be pediatricians. In the meantime, I’m going to keep terrorizing University of Chicago residents until they come with a body bag and wheel barrel into my office.”
ASTRO was also present for the funeral but declined to comment because they think they are under surveillance by the anti-trust division of the feds. “We can’t comment on radiation oncology’s death. We aren’t allowed to advocate for the specialty” they whispered under their breath.
Lisa Kachnic gave the euology. She blamed small programs for the demise of the specialty. She said the data to back up her claim is still maturing. She was confident she was right this time as opposed to the last time she claimed small programs did worse on board exams. That statement led to a forced retraction one year later. “I still make no apologizes for the ABR board fiasco and I am the victim of cyberbullying so f**k off” were her final departing words to radiation oncology.
In lieu of flowers, donations may be made to the debt of current residents. Cambodia does not pay as well as we had hoped.
