Is it Time to Break with ABR?

[Chartreuse Wombat]

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TIme for a Poll (and no I don't intend to publish in RJ)

 

[Mandelin Rain]

Resounding yes. Not sure how our specialty moves forward as part of the ABR. Too much baggage. Lawsuits. Board debacles. Inflexibility. Retracted coercive agreements. Threatening residents. It's insane. And that's just in 2 years.

EDIT: Maybe the fault is primarily with those running the rad onc side and wholesale changes in leadership there would improve the situation. But ABR has had some issues on the rads side as well.

 

[elementaryschooleconomics]

Perhaps having a Senior VP of 21C be the ABR Executive Director of RadOnc was not our best decision as a specialty

 

[evilbooyaa]

Short answer, yes, I think so.

 

[medgator]

Perhaps having a Senior VP of 21C be the ABR Executive Director of RadOnc was not our best decision as a specialty

They know how to pick 'em...

 

[scarbrtj]

OK. Then what. We just stop taking OLA? We stop paying the dues obviously. The *only* way this works is if every rad onc makes an ironclad decision to both, and every resident makes an ironclad decision not to pursue ABR board certification. On its face this sounds, well, you know, like some right-wing, nutjob, separatist conspiracy. Can people be comfortable with that?

But I will say this: the person that the ABR just cyberbullied should get board certified by her residency program. Or fly a couple ABR rad oncs out to her for orals sometime, somewhere. Or maybe we just grant her a certificate now, and either way make it lifetime. If Paul Wallner gets a lifetime certificate she does too. Special dispensation. She doesn't need to deal with the ABR again, ever, in her life. It is time at least for her to break with the ABR. She's faced sex discrimination and the ABR trying to abridge her civil rights. While I don't believe we can get everyone to break with the ABR, which is what's needed to really torpedo it, I think it would be a start by letting HER break with the ABR. And any woman that feels the ABR has sex discriminated against them: same thing. Lifetime certificate. No dues paid.

What is it they say, "The journey of a thousand miles begins with a single step." All it takes is one weak point in the wall for it to crumble.

 

[Gfunk6]

I think "cleaning house" at the ABR is more constructive and likely a solution than creating an entirely new medical board.

 

[Mandelin Rain]

Could be. Will have to see what the response of the ABR is to the most recent kerfuffle. At some point you just have to pull the ripcord if their interests are too large and/or entrenched to change.

 

[thecarbonionangle]

I think "cleaning house" at the ABR is more constructive and likely a solution than creating an entirely new medical board.

Justice delayed is too often JUSTICE DENIED. People are always saying wait for a better time!! TIMESUP.

 

[w00tz]

Justice delayed is too often JUSTICE DENIED. People are always saying wait for a better time!! TIMESUP.

Need to defund these bastards!

 

[thecarbonionangle]

Need to defund these bastards!

you’re onto something there, mate!

 

[medgator]

I think "cleaning house" at the ABR is more constructive and likely a solution than creating an entirely new medical board.

The idea of separation is a good "warning shot" across the bow imo to get us there

 

[GapCalc]

I agree with scarbjt, it would be a monumental undertaking. However, I have spoken with a few colleagues (some of whom are current or former volunteers for the ABR) and they are open to a new board. I know a lot of the younger folks (residents, recent grads) don't feel a particular affinity for ABR. This has been highlighted by recent Twitter posts. I'm not sure what this is about the ABR silencing someone on Twitter, but even without that, they don't seem to behave like an organization I want representing myself and my colleagues after the hard work we did to earn our positions.

That being said, I don't particularly care if there is a new board or a reformed ABR, but things really need to change.

My proposal: make board positions (including board leadership) with the ABR voted on by the ABR membership. If you've been a member in good standing for X years, you have the ability to vote. If you've been a member in good standing and voted for Y years, you can run for a position. Put out a platform. Say what policies you are for/against. Let the people who make up the constituency (radiologists and rad oncs and physicists) decide who they want to be their leader in a direct fashion.

Valerie Jackson previously said something along the lines of, "if we don't maintain our own standards, someone else will do it for us" (I am admittedly offering a gross paraphrase). I always interpreted this statement to mean, a government body unaccountable to radiologists and radiation oncologists would make up standards for us. But the current situation does not seem drastically different from an out-of-touch bureaucrat making decisions on my behalf. At least in that instance, they'd be getting a standard government salary and not many hundreds of thousands of dollars a year...

 

[w00tz]

I agree with scarbjt, it would be a monumental undertaking. However, I have spoken with a few colleagues (some of whom are current or former volunteers for the ABR) and they are open to a new board. I know a lot of the younger folks (residents, recent grads) don't feel a particular affinity for ABR. This has been highlighted by recent Twitter posts. I'm not sure what this is about the ABR silencing someone on Twitter, but even without that, they don't seem to behave like an organization I want representing myself and my colleagues after the hard work we did to earn our positions.

That being said, I don't particularly care if there is a new board or a reformed ABR, but things really need to change.

My proposal: make board positions (including board leadership) with the ABR voted on by the ABR membership. If you've been a member in good standing for X years, you have the ability to vote. If you've been a member in good standing and voted for Y years, you can run for a position. Put out a platform. Say what policies you are for/against. Let the people who make up the constituency (radiologists and rad oncs and physicists) decide who they want to be their leader in a direct fashion.

Valerie Jackson previously said something along the lines of, "if we don't maintain our own standards, someone else will do it for us" (I am admittedly offering a gross paraphrase). I always interpreted this statement to mean, a government body unaccountable to radiologists and radiation oncologists would make up standards for us. But the current situation does not seem drastically different from an out-of-touch bureaucrat making decisions on my behalf. At least in that instance, they'd be getting a standard government salary and not many hundreds of thousands of dollars a year...

Okay, you have my vote.

 

[Mandelin Rain]

ABR just has a lot of baggage currently. Not thrilled with my dues going to defend a class action brought forth (probably justified) by docs of another specialty. But yes, I don't really care what the acronym is. It could be ABR, ABRO, or whatever... Something needs to change.

 

[evilbooyaa]

A board has separated from a previous board in the past. American Board of Plastic Surgery seems to have done it in maybe 1941, breaking apart from American Board of Surgery, to create their own certification board.

 

[RadOncMegatron]

Aren't there multiple non-standard board certifying bodies? I think Rand Paul even made his own. If ACRO, ACR, or ASTRO, even MSKCC or MDACC made their own board, I think many hospitals will eventually accept those.

Honestly right now, the ABR OLA is about as easy as it's going to get. Not sure I want to ruin that b/c if I really don't want to have to take a test every 10 years and waste a month or 2 of my life studying for an abomination of a test. Game theory wise, paying $400 and 2 easy questions a week >>> Long test, requiring extensive review, every 10 years.

If we dismantle ABR, I'm afraid of the monster that will seek to replace it. If we got rid of the need for SAMs (which I think we can) and just did these OLAs I'd be happy, so we better be careful what we are wishing for...

 

[thecarbonionangle]

Aren't there multiple non-standard board certifying bodies? I think Rand Paul even made his own. If ACRO, ACR, or ASTRO, even MSKCC or MDACC made their own board, I think many hospitals will eventually accept those.

Honestly right now, the ABR OLA is about as easy as it's going to get. Not sure I want to ruin that b/c if I really don't want to have to take a test every 10 years and waste a month or 2 of my life studying for an abomination of a test. Game theory wise, paying $400 and 2 easy questions a week >>> Long test, requiring extensive review, every 10 years.

If we dismantle ABR, I'm afraid of the monster that will seek to replace it. If we got rid of the need for SAMs (which I think we can) and just did these OLAs I'd be happy, so we better be careful what we are wishing for...

your point is a valid concern but i would argue it is unfounded. When change is proposed there is always concern the new normal will be worst. Certainly a valid thought but i think we must move forward with this scenario in back of our minds to make us pay attention. It would be just as equally plausable that new governing body is better or worst. What would determine the outcome is if people are engaged and ensure it is responsive to the constituents. I don’t think the people who want to get rid of the ABR want to bring back the certification exam every 10 years. All potential benefits would help even older guys like yourself, get rid of MOC corruption, improve on the process. At some point you gotta take a gamble, try something new. The old way to do things is NOT working!

 

[evilbooyaa]

Aren't there multiple non-standard board certifying bodies? I think Rand Paul even made his own. If ACRO, ACR, or ASTRO, even MSKCC or MDACC made their own board, I think many hospitals will eventually accept those.

Honestly right now, the ABR OLA is about as easy as it's going to get. Not sure I want to ruin that b/c if I really don't want to have to take a test every 10 years and waste a month or 2 of my life studying for an abomination of a test. Game theory wise, paying $400 and 2 easy questions a week >>> Long test, requiring extensive review, every 10 years.

If we dismantle ABR, I'm afraid of the monster that will seek to replace it. If we got rid of the need for SAMs (which I think we can) and just did these OLAs I'd be happy, so we better be careful what we are wishing for...

I don't know anybody that is suggesting that we return to archaic MOC 10-year testing periods for board certification. I don't see a reason why that would change going from ABR to a new board.

Maybe expanding MOC to include all physicians regardless of their historical board certification status (but even that is unlikely)

 

[Mandelin Rain]

Yes, I think you get folks with skin in the game running the show, i.e. non-grandfatherable (I understand current ABR leadership participates in MOC) with minimal pay, who are doing more as a passion project in their free time. They would streamline it to a point that they feel comfortable with the time commitment they are asking of themselves and their partners. They may actually take the time to develop a legitimate curriculum to define relevant knowledge for clinical competence. The whole process should be one highly relevant and comprehensive test for initial cert and a more relevant OLA type thing for ongoing moc. There doesn't need to be some massive overhead and bureaucracy. It shouldn't cost a thousand dollars per year in dues and special CME for everyone participating.

 

[Radonc90]

The reason we are still with ABR is historical.
Many many moons ago, radonc depts were part of radiology depts as you guys/girls know.

The way to break with ABR: since we are more closely aligned with the surgeons, we can ask ABS (Am Bd of Surgery) for advice.
We (radonc) are basically surgeons w/o the knife.
Then file a divorce and call it ABRO, then we run our own show with respect, integrity and transparency.
And we listen to the constituents and make it democratic and better.
I am biased but I think radonc's are better than the radiologists

The con is: radonc is outnumbered by radiologist. There is this ratio from the 1990s (before the current expansion of ~180-200 residents/year).
Back in the 1990s: there were some 120 radonc grads/yr vs 1150 dxrad grads/yr. So the ratio is roughly 1:10 for radonc vs dxrad.

BTW, I did my exam back in the 1990s, to this date, I still hate to see my board certification saying "American Board of Radiology" on the top of the diploma. For God's sake, I am not a radiologist! I am a radonc.

PS: Re ABR virtual exam, it'd be funny if all 2020 grads file a dispute with VISA (or whatever credit cards used). Whenever you buy a product using VISA and have an issue, you file a complaint with VISA, which will hold the funds until the issue is resolved. In this case, the complaint is "I paid $640 but they did not deliver the product". So, let's say 200 grads x $640 = $128,000 of funds on hold! Now money speaks and ABR will have to respond...Oh WW III just started lol...

 

[Gfunk6]

.
Then file a divorce and call it ABRO, then we run our own show with respect, integrity and transparency.

If we are going to divorce, I want alimony!

 

[medgator]

 

[scarbrtj]

if rad onc doesn't work out for Simul he can always become a professional bear poker

 

[radoncgrad2019]

Someone should teach the guy about Eugene gu

 

[medgator]

Someone should teach the guy about Eugene gu

Hadnt heard that name before. Interesting story

Social justice personality Eugene Gu has a history of abuse

Behind one of Twitter’s most outspoken social justice figures is a story of manipulation and sock-puppet accounts

www.theverge.com

 

[scarbrtj]

Someone should teach the guy about Eugene gu

Simul ≠ Gu
Nothin but love for the Simul

 

[radoncgrad2019]

Eugene sucks I agree, simul cool, just want to make sure he doesn’t get in too much trouble poking all the bears

 

[thecarbonionangle]

“If you come for the queen you best not miss”!!!

 

[evilbooyaa]

Eugene sucks I agree, simul cool, just want to make sure he doesn’t get in too much trouble poking all the bears

Not close to the same situation. Granted if Simul was a resident then maybe. He's not going to criticize MDACC, given the affiliation his center has, but there is no immediate harm to his career by speaking out now.

 

[radoncgrad2019]

yeah probably not - but he has been told to delete tweets before (he said this on twitter). he works for MDACC, not a lone wolf with no cares in the world.

 

[RadOncLazers]

Absolutely. The poll numbers would agree. So what next?

 

[rymd]

ABR is listening? Will be interesting to see what they can come up with..

" We have been meeting with numerous stakeholder groups over the past few months and have increased these discussions recently, as it has become clear that we cannot hold our in-person exams as planned."

 

[Neuronix]

We should have fired the rad onc board exam leadership when they failed somewhere on the order of a half of current graduates and never explained why. Instead they put Lisa Kachnic in front of the residents with legal counsel at her side and no explanation. Then they changed their terms of use with vague and threatening terms that they can do whatever the heck they want to us. Now Wallner is openly bullying a new grad while they can't even seem to give the same class they previously failed half of an oral examination (which is antiquated anyway IMO).

Why are we giving these "leaders" another chance? I'd be fired by now if I made this many major mistakes in my job.

Biggest priority for me is to remove Wallner and Kachnic. I'm fine to separate from ABR while we're at it because I'm not interested in the head of ABR making around $700k a year thanks in part to my dues. I can't even make half that, and I'm actually out here trying to help someone.

 

[scarbrtj]

Now Wallner is openly bullying a new grad

overheard: he is now diversifying his bullying to men, and non-new grads. Way to go PW?

 

[radoncgrad2019]

I can't even make half that

are you being facetious

 

[Neuronix]

are you being facetious

Yes, sorry, I'm actually not trying to help anyone.

 

[Carotenoid]

Hadnt heard that name before. Interesting story

Social justice personality Eugene Gu has a history of abuse

Behind one of Twitter’s most outspoken social justice figures is a story of manipulation and sock-puppet accounts

www.theverge.com

lol I wasn't familiar with the story and assumed you were referring to a GU practice in Eugene, OR

 

[Carotenoid]

Not close to the same situation. Granted if Simul was a resident then maybe. He's not going to criticize MDACC, given the affiliation his center has, but there is no immediate harm to his career by speaking out now.

Simul is amase-balls

 

[medgator]

lol I wasn't familiar with the story and assumed you were referring to a GU practice in Eugene, OR

It was @radoncgrad2019 with the original reference, i just googled around... Crazy story (ies) about that guy though

 

[Carotenoid]

Need to defund these bastards!

we must all agree to not pay our dues - at the very least

 

[thecarbonionangle]

We should have fired the rad onc board exam leadership when they failed somewhere on the order of a half of current graduates and never explained why. Instead they put Lisa Kachnic in front of the residents with legal counsel at her side and no explanation. Then they changed their terms of use with vague and threatening terms that they can do whatever the heck they want to us. Now Wallner is openly bullying a new grad while they can't even seem to give the same class they previously failed half of an oral examination (which is antiquated anyway IMO).

Why are we giving these "leaders" another chance? I'd be fired by now if I made this many major mistakes in my job.

Biggest priority for me is to remove Wallner and Kachnic. I'm fine to separate from ABR while we're at it because I'm not interested in the head of ABR making around $700k a year thanks in part to my dues. I can't even make half that, and I'm actually out here trying to help someone.

somebody help this guy make some real money folks!!!!

 

[radoncgrad2019]

Yes, sorry, I'm actually not trying to help anyone.

agree with carbonionangle

hard to believe someone who has been in practice for 5 years when they claim they 'can't make 350k'

i would not call BS on a mod...

but what

 

[Neuronix]

If it helps you feel better I was offered $280k recently.

25th percentile AAMC assistant professor 4 lyfe.

 

[medgator]

agree with carbonionangle

hard to believe someone who has been in practice for 5 years when they claim they 'can't make 350k'

i would not call BS on a mod...

but what

If someone is geographically constrained, very easy to believe. Think: much of Cali (desirable areas), Boston, NYC, wouldn't surprise me if sought after southern metros with a tight job market also fell into that category.

The pick 2/3 thing has always been true and geography and salary have always been the 2 big competing factors in any job.

 

[radoncgrad2019]

If it helps you feel better I was offered $280k recently.

25th percentile AAMC assistant professor 4 lyfe.

I guess more context here?

Satellite Doc Experience

Really nice thread from SimulD

forums.studentdoctor.net

 

[Neuronix]

I don't know why it's such a surprise to you that an academic rad onc makes academic rad onc salary.

 

[Old rad onc]

350 is a median and average income. That will probably be a good number in the future. It is hard getting a job in California. Even locums is getting to be difficult. With 25% unemployment it is 7x the median income in the US. With round 2 of Covid coming, it's probably going to get harder on the job market! We will all be happy to have one........

 

[radoncgrad2019]

I don't know why it's such a surprise to you that an academic rad onc makes academic rad onc salary.

academic rad onc is a broad term

physician scientist with 50% clinical effort makes more sense, even 5 years in or so. 350k makes sense, depending on whether you are assistant or associate.

 

[medgator]

I don't know why it's such a surprise to you that an academic rad onc makes academic rad onc salary.

Not the case at mdacc apparently