List of programs expanding

[deleted950463]

I agree but this actually brings up a good point . . . I honestly don't know but I'm pretty sure the majority of people who post (or definitely view?) this forum are not oncologists but students and maybe residents so therefore the emphasis can't be on talking about treating cancer or discussion among peers about difficult cases. I've been on this forum for something like 15 years since it was actually mostly medical students but I wonder if it's time to create a sub-forum or section or whatever dedicated to discussion of interesting cases/strictly clinical situations geared more towards practicing radiation oncologists (that everybody can view of course) and other sections for matching, jobs, or just "everything else"

That’s more like a website with 5 letter word that starts when an S.

---

Members don't see this ad.

 

[deleted18755]

That’s more like a website with 5 letter word that starts when an S.

I have no idea what you’re talking about, but then again when I started getting on this forum Bill Clinton was president and when I went home for the holidays I logged on with a dial up connection from my parents’ house ... maybe it’s time for me to figure out exactly what Twitter is, or more importantly why I would need it, or move on!

Seriously though maybe it is time to update this forum since the original “student doctors” are in their 40’s? It’s depressing to hear about where this field is headed while knowing there is nothing we can do about it but that we’ve stated our opinion multiple times so I think like nepolian I’m checking out too other than for clinical questions/interesting case discussions.

 

[KHE88]

It would be nice to create a password-protected "private forum" off of SDN. Other specialties have these that allow you to post anonymously, but in order to gain access and view posts you have to prove your credentials by providing some proof like a national society member ID or something. Could potentially increase chatter by bringing in those afraid to touch the drama and risks associated with public-nature of SDN.

 

[Burt Radnolds]

Long time lurker, rare commenter.

This forum is at its best when there is a discussion between peers regarding the best way to approach a difficult case. All readers can benefit from such a dialogue. Conversations such as this are a low point. If you are regretting your decision to become a rad onc because you are worried that the match is getting too easy, or you think just having an MD makes you a better doctor than DOs or FMGs, I sincerely hope that I never have to work with you. We are all oncologists, so let's talk about treating cancer.

Sometimes the truth hurts. I love radiation oncology and would not change my career choice if I could go back in time, but the field is going down the toilet. Sure whining about it on the internet may not help that much, although it might have more of an effect that you think and it's better than doing nothing IMO.

If you don't like these threads, don't read them. They are factual in my opinion and why should we stick our heads in the sand. I agree that the banter on cases is much more enjoyable but med students also deserve to know the state of the field (it is called student doctor...).

 

[RickyScott]

It is not about whether or not this field is exclusive. Pretty much everything takes a backseat to finding a job for a trainee or medstudent. The entrance of FMG/DOs is not inherently a problem in and of itself, just if it reflects an underlying issue with the job market. It has become very clear that a lot of programs and ASTRO leadership do not have medstudents/residents best interests at heart. This forum is probably the best way to reach them. No one should enter this field without being aware of the jobs issue. I honestly see this as a public service to the field.

 

[OTN]

These threads contain valuable information for prospective radonc residents, so I do think they're valuable. We ALL wish our leadership weren't so spineless to send us down this path, but that hasn't been the case, so here we are.

Back when I was applying there was a lot of discussion about programs, applying, etc, as getting in was damn near impossible, so that's mostly what we talked about. The board in general as mentioned before has traditionally revolved around med students/residents, and I would expect them to focus feverishly on their future.

Fortunately, the solution is simple: if you don't want to read these types of threads, just ignore them. That seems to be ASTRO's game plan (sorry, I couldn't resist).

 

[thecarbonionangle]

Some are badly afflicted by snowflakism. If you do not want read the truth, DONT. Plenty of fake news out there. ASTRO leadership will tell you it is all great. Read that! Here you can read the suffering of your fellow residents. Ignore it if you want. Spare me the fake outrage.

 

[deleted18755]

I am a graduating PGY5 still without any interviews. If anyone has any job leads in a big city on the coast or Chicago, please feel free to PM me.

Ok last response on this post at least: I think a lot of the disconnect is because some people simply don't believe posts like this and figure it's trolling or if it's the case then it must be because "entitled millennials" expect to make a million dollars in the middle of Manhattan working 30 hours a week, because apparently there are so many good jobs out there that just aren't posted, etc.

Even during the best of times finding a job in any particular market (especially a desirable one of course) was difficult, but even I find it hard to believe that somebody who is graduating this year 1. cannot get an interview in ANY coastal city or Chicago (isn't that literally more than half of the US population?) 2. even more so doesn't have a single faculty member who can hook him up with at least an interview?

Again, I have no idea if you're a superstar or barely competent weirdo (actually even weirdoes get interviews but no offers) but in either event when I was training even the lazier and less involved faculty members did everything they could to help graduates find a position after graduation and the chair/vice chair considered it part of their job.

I'm curious: it's already January and you don't have an interview let alone a job offer, what do your program director and chair think about this situation and are advising you to do?

 

[w00tz]

Can someone explain how this thread will be helpful to our field? Genuinely curious. Are we suggesting medical students not apply/rank these programs? Employers not hire grads from these programs? What about programs like MDACC that went from 6 to 7 residents a year?

 

[medgator]

Ok last response on this post at least: I think a lot of the disconnect is because some people simply don't believe posts like this and figure it's trolling or if it's the case then it must be because "entitled millennials" expect to make a million dollars in the middle of Manhattan working 30 hours a week, because apparently there are so many good jobs out there that just aren't posted, etc.

Agree!

Even during the best of times finding a job in any particular market (especially a desirable one of course) was difficult, but even I find it hard to believe that somebody who is graduating this year 1. cannot get an interview in ANY coastal city or Chicago (isn't that literally more than half of the US population?)

There's an NYC job in Manhattan posted literally every year on ASTRO .. Prob the same one over and over. In this day in age applicants should be expecting to get 1/3, maybe 2/3 if they are very lucky.

Agree there are probably jobs out there right now in a major coastal city ... The question is salary/job quality and that's where compromise will likely need to happen, whether graduating PGY5s like it or not.

The job market has never been amazing to begin with, less so now.

 

[RickyScott]

Agree!



There's an NYC job in Manhattan posted literally every year on ASTRO .. Prob the same one over and over. In this day in age applicants should be expecting to get 1/3, maybe 2/3 if they are very lucky.

Agree there are probably jobs out there right now in a major coastal city ... The question is salary/job quality and that's where compromise will likely need to happen, whether graduating PGY5s like it or not.

The job market has never been amazing to begin with, less so now.

Gil Lederman/ hires every year in Manhattan. It is apparently bring your own patients/salary, and I am not sure he has had many takers. Many applicants because they have a spouse with a grduate degree/career are beholden to metropolitan areas, where most of the population lives. ie Female grads married to a lawyer banker scientist etc (male spouse may not be as agreeable to becoming stay at home parent in Iowa.) Yes, there is some inherent "sexism" to rural positions, and it is another factor contributing to oversupply in urban markets.
You may get 1 of the 3, but you also may not get to choose which one.
The Doctor Can't Help Himself
Controversial Staten Island Doctor Settles Medicare Fraud Case for $2.35 Million

 

[DukeNukem]

I'm curious: it's already January and you don't have an interview let alone a job offer, what do your program director and chair think about this situation and are advising you to do?

You are so naive.

When I graduated from residency a few years ago, the chairman, vice chairman, and program director all refused to make phone calls for any of the graduating class. There was always some stupid excuse or reason for it. That's how it is every year for them. Their advice? Take a fellowship with them. They want fellows. They're so much cheaper than hiring faculty. They are salivating about the job crunch.

I know three chairs well and they all think and act the same way. They are not interested in helping their graduates unless it helps them. How can you help them? Go staff a satellite clinic and steal patients away from the private group that are making double what you'll ever make. Where does that extra money go? To their bonus, obviously. Their bonus is based on department growth and expanding the departmental budget. How do the expenses go down? Pay the docs less. How does revenue go up? Work the docs harder. It's simple dollars and cents. Oh the job market is getting tight you say? That's great, we should hire more instructors or fellows. Also, we should tighten the screws on you. Where else are you going to go? The rural midwest? Not anywhere around here of course--even if you're well liked, where are you going to go with your gigantic non-compete anyway?

This field is sick. Stay away.

 

[RickyScott]

You are so naive.

When I graduated from residency a few years ago, the chairman, vice chairman, and program director all refused to make phone calls for any of the graduating class. There was always some stupid excuse or reason for it. That's how it is every year for them. Their advice? Take a fellowship with them. They want fellows. They're so much cheaper than hiring faculty. They are salivating about the job crunch.

I know three chairs well and they all think and act the same way. They are not interested in helping their graduates unless it helps them. How can you help them? Go staff a satellite clinic and steal patients away from the private group that are making double what you'll ever make. Where does that extra money go? To their bonus, obviously. Their bonus is based on department growth and expanding the departmental budget. How do the expenses go down? Pay the docs less. How does revenue go up? Work the docs harder. It's simple dollars and cents. Oh the job market is getting tight you say? That's great, we should hire more instructors or fellows. Also, we should tighten the screws on you. Where else are you going to go? The rural midwest? Not anywhere around here of course--even if you're well liked, where are you going to go with your gigantic non-compete anyway

This field is sick. Stay away.

My department also refused to provide active help finding a job. Chair was really pressuring me to take research fellowship.

 

[DukeNukem]

My department also refused to provide active help finding a job. Chair was really pressuring me to take research fellowship.

Even this is a gimmick.

What's a research fellowship to anyone outside rad onc? One day a week of clinic or 80% research.

What was I offered by multiple academic institutions? 50% - 80% clinical "research fellowships". I even tried to negotiate with a big name academic place for an 80% research fellowship and was turned down. 50% clinical was the best they could do. After talking with the desperate Canadians who took those positions they turned out to be 80% clinical.

 

[thecarbonionangle]

I actually had a couple interviews set up in desirable cities. All got canceled before I could go. Not sure what happened. Maybe the jobs got filled really quick...

So whats your plan?

 

[RickyScott]

Even this is a gimmick.

What's a research fellowship to anyone outside rad onc? One day a week of clinic or 80% research.

What was I offered by multiple academic institutions? 50% - 80% clinical "research fellowships". I even tried to negotiate with a big name academic place for an 80% research fellowship and was turned down. 50% clinical was the best they could do. After talking with the desperate Canadians who took those positions they turned out to be 80% clinical.

of course, the research is outside of clinic hours.

 

[thecarbonionangle]

What do you consider city on coast? Not midwest? has to have a swimable beach?

 

[KHE88]

You are so naive.

When I graduated from residency a few years ago, the chairman, vice chairman, and program director all refused to make phone calls for any of the graduating class. There was always some stupid excuse or reason for it. That's how it is every year for them. Their advice? Take a fellowship with them. They want fellows. They're so much cheaper than hiring faculty. They are salivating about the job crunch.

I know three chairs well and they all think and act the same way. They are not interested in helping their graduates unless it helps them. How can you help them? Go staff a satellite clinic and steal patients away from the private group that are making double what you'll ever make. Where does that extra money go? To their bonus, obviously. Their bonus is based on department growth and expanding the departmental budget. How do the expenses go down? Pay the docs less. How does revenue go up? Work the docs harder. It's simple dollars and cents. Oh the job market is getting tight you say? That's great, we should hire more instructors or fellows. Also, we should tighten the screws on you. Where else are you going to go? The rural midwest? Not anywhere around here of course--even if you're well liked, where are you going to go with your gigantic non-compete anyway?

This field is sick. Stay away.

Spot on.

The only decent opportunities in this field are currently in the midwest or many hours from a large metro. To tell a medical student anything else is an outright lie. If you are unwilling to look there, you are probably going to start your career in a dead end underpaid job, an exploitative academic job or psuedo-fellowship, or competing for bottom-dollar scraps in the locums pool.

The amount of cognitive dissonance I am seeing among medical students this year is astounding. They are all convinced that this forum is total hyperbole.

And our pals at ARRO are spreading the ASTRO party line as well in their advice to medical students: ARROgram - American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

With respect to things like job market, overtraining, and exploitation of new grads, comments like these just indicate "meh...this isn't really a problem and lets not try to talk about it..."

"Take any negativity about the field and the discussions on internet forums with a grain of salt. Radiation oncology is an amazing specialty and there are many opportunities to succeed. Ask targeted questions and you will find that most radiation oncologists very much love what they do."

"Speak with physicians and residents in the field: Most information on the internet is from a handful of individuals. Make sure to talk to residents and attendings in-person or by email in order to get the real story."

So we are not actual attendings or residents in the field? Just a handful of "individuals"/imposters/trolls? Or is it only the attendings and residents with a positive outlook/heads-buried-in-the-sand whose opinions matter and have the "real story"? Gimme a break...

 

[deleted18755]

You are so naive.

When I graduated from residency a few years ago, the chairman, vice chairman, and program director all refused to make phone calls for any of the graduating class. There was always some stupid excuse or reason for it. That's how it is every year for them. Their advice? Take a fellowship with them. They want fellows. They're so much cheaper than hiring faculty. They are salivating about the job crunch.

I know three chairs well and they all think and act the same way. They are not interested in helping their graduates unless it helps them. How can you help them? Go staff a satellite clinic and steal patients away from the private group that are making double what you'll ever make. Where does that extra money go? To their bonus, obviously. Their bonus is based on department growth and expanding the departmental budget. How do the expenses go down? Pay the docs less. How does revenue go up? Work the docs harder. It's simple dollars and cents. Oh the job market is getting tight you say? That's great, we should hire more instructors or fellows. Also, we should tighten the screws on you. Where else are you going to go? The rural midwest? Not anywhere around here of course--even if you're well liked, where are you going to go with your gigantic non-compete anyway?

This field is sick. Stay away.

I don’t know what to say other than things sure appear to have changed dramatically

 

[imhopeful432]

I'm a resident at a solidly middle to middle-upper tier program - our PGY-5 residents have gotten academic and private interviews this year in LA, NYC, Chicago, Atlanta, Florida as well as places in between. Our faculty actively discouraged them from taking satellite jobs (though I heard of a few far and in between satellite jobs too that seemed decent). My PD actively called/emailed and helped make connections for our residents so they could land these interviews - which probably made a huge difference.

I'm obviously quite happy with my residency choice if I end up in a similar spot as my current seniors when I'm graduating. I also was a middle of the pack type of applicant - so I did see programs where residents struggled with job interviews, many did fellowships. I had a rule to rank any program that had more than 1 resident do a fellowship in the past 5 years at the bottom of my rank list (and I did this for a couple programs where I loved the location/program on my interview day).

So I actively advise med students that I think the field is awesome and I would pick this field over any other specialty, but that's clearly not universally true depending on where you go for residency.

 

[Krukenberg]

I'm a resident at a solidly middle to middle-upper tier program - our PGY-5 residents have gotten academic and private interviews this year in LA, NYC, Chicago, Atlanta, Florida as well as places in between. Our faculty actively discouraged them from taking satellite jobs (though I heard of a few far and in between satellite jobs too that seemed decent). My PD actively called/emailed and helped make connections for our residents so they could land these interviews - which probably made a huge difference.

I'm obviously quite happy with my residency choice if I end up in a similar spot as my current seniors when I'm graduating. I also was a middle of the pack type of applicant - so I did see programs where residents struggled with job interviews, many did fellowships. I had a rule to rank any program that had more than 1 resident do a fellowship in the past 5 years at the bottom of my rank list (and I did this for a couple programs where I loved the location/program on my interview day).

So I actively advise med students that I think the field is awesome and I would pick this field over any other specialty, but that's clearly not universally true depending on where you go for residency.

Obviously there are strong opinions here about satellite jobs. What were the cited reasons from faculty about avoiding satellite jobs?

 

[medgator]

Obviously there are strong opinions here about satellite jobs. What were the cited reasons from faculty about avoiding satellite jobs?

PP hours for academic pay?

 

[imhopeful432]

Obviously there are strong opinions here about satellite jobs. What were the cited reasons from faculty about avoiding satellite jobs?

Basically PP hours/work for academic pay. One resident got a job offer at a satellite in a desirable location that paid mid 200k starting salary + RVU bonus, 4 busy clinic days a week + 1 "academic day" (but probably not really), and promised parity with academic physicians at the main sites....but our PD told him that you're not actually going to build your academic career at a place like that if that's your goal and you might as well do PP somewhere else with similar job description/double the pay if you don't care about academic career.

 

[RickyScott]

Can someone explain how this thread will be helpful to our field? Genuinely curious. Are we suggesting medical students not apply/rank these programs? Employers not hire grads from these programs? What about programs like MDACC that went from 6 to 7 residents a year?

I am suggesting medstudents not rank these programs and employers consider not hiring grads. Again, there are more than enough spots for all medstudents, so why would you want to enter these programs when you can attend an existing program. The new programs cant possibly care about residents and their education if they are opening during such a glut.
In terms of MDACC and 6-7 residents, this is hard to target ( and certainly doesnt mean we shouldnt go after the new programs), but with time and a souring job market there will be a lot of disaffection and support for lobbying to lower proton reimbursement which are going to be key to all these types of programs and all their satellites.

 

[medgator]

In terms of MDACC and 6-7 residents, this is hard to target, but I think with time and a souring job market there will be a lot of disaffection out there and there will be a lot of support for lobbying to lower proton reimbursement which are going to be key to all these types of programs.

For those looking at PP, pedigree from the likes of mskcc or mdacc won't be of much help outside of their alumni network. Personally, I think someone coming from a mid tier established clinically busy program who embodies the 3 "A's" is likely to be far more successful in the PP job search

 

[PointA]

These threads contain valuable information for prospective radonc residents, so I do think they're valuable. We ALL wish our leadership weren't so spineless to send us down this path, but that hasn't been the case, so here we are.

Back when I was applying there was a lot of discussion about programs, applying, etc, as getting in was damn near impossible, so that's mostly what we talked about. The board in general as mentioned before has traditionally revolved around med students/residents, and I would expect them to focus feverishly on their future.

Fortunately, the solution is simple: if you don't want to read these types of threads, just ignore them. That seems to be ASTRO's game plan (sorry, I couldn't resist).

This is spot on. About 5-7 years ago, lots of the threads were "what are my chances" posts in which applicants would share their board scores and research stats with the fear of going unmatched. Now there are more than enough residency spots and the threads have shifted to "where will I be able to get job" type posts and there is genuine fear about current job prospects. This clearly represents a real shift in the dynamics of the field.

 

[medgator]

. Now there are more than enough residency spots and the threads have shifted to "where will I be able to get job" type posts and there is genuine fear about current job prospects. This clearly represents a real shift in the dynamics of the field.

Exacerbated by trends of increasing hypofx/sbrt in certain indications and surveillance/no xrt in favorable breast and prostate patients

It's really been a perfect storm for those looking for jobs now, as there are more grads coming out while existing docs are just seeing more patients because of the trends I mentioned.

Residency expansion given the above has been truly unconscionable.

 

[Old rad onc]

Exacerbated by trends of increasing hypofx/sbrt in certain indications and surveillance/no xrt in favorable breast and prostate patients

It's really been a perfect storm for those looking for jobs now, as there are more grads coming out while existing docs are just seeing more patients because of the trends I mentioned.

Residency expansion given the above has been truly unconscionable.

What we are hoping to accomplish is to stop academics from continuing the expansion which is certain to decimate medical students and residents in our field for a very long time. I feel that the current situation is already obvious to med students applying to the field this past year which is reflected in the fewer applicants, but the match is now 2-3 months away. There are more reasons why our field should be cautious with its residency expansion but clearly is not. Foremost in my mind is the new Secretary of health, who is a former exec in the pharma industry Mr Azar, who replaced Tom Price MD who sought to protect physician autonomy and reimbursement. Azar is pushing for mandatory bundled payments and Rad Onc is his initial target. He stated it in a speech a month or 2 ago. We maybe under the gun very soon.

Secondly, in addition to what Medgator succinctly pointed out, most of the money and control of cancer has already shifted to Med Onc. Doctors and hospitals will be targeted for more cuts. I think hypofractionation was a move by ASTRO and academics in anticipation of bundled payments and prefixed pricing in rad Onc.

We who are challenging the ivory towers are mostly set with are practices and many may already be on a path in which the future may hurt us but not kill us. But it is hard for me to imagine what the future will be like for future job seekers in he field. We have talked about 1 out 3 for location, hours, and money. How about 0 out of 3, with no money , no partnership and maybe no job. I fear the field is already down a hard path, but the expansion is beyond insanity, and I must conclude that those who want it, want it for heir own gain.

For us to say nothing is also ridiculous. So we refuse and shall continue to do what we think is right. You are welcome to defy the logic but the numbers already speak for themselves. I am twice as busy with patients as I was 10 years ago but my income continues to decline. I am ok with that, more or less as I have no choice. But if I were a med student and I knew the facts I would be wary of this field..... even if I were a DO or FMG which the work you put in I respect.

 

[Neuronix]

Basically PP hours/work for academic pay. One resident got a job offer at a satellite in a desirable location that paid mid 200k starting salary + RVU bonus, 4 busy clinic days a week + 1 "academic day" (but probably not really), and promised parity with academic physicians at the main sites....but our PD told him that you're not actually going to build your academic career at a place like that if that's your goal and you might as well do PP somewhere else with similar job description/double the pay if you don't care about academic career.

Five years ago this was fine advice. Avoid academic satellites because the pay isn't good and you won't build an academic career.

Now these academic satellite jobs are the only things available in many markets. I've seen graduating residents apply to everywhere in a region or two regions and academic satellite is all they could come up with. With the saturated job market, academic satellite is the job many residents are expecting as it's all they can hope for.

PS: Be very skeptical of RVU bonuses. They tend to be much smaller than anticipated. There tend to be complex formulas, ever changing targets, budget shortfalls, and quality metrics that keep you from getting what you expected.

 

[nkmiami]

Clearly hypofractionation and more selective use of radiation is beneficial to patients and is the future of our field. I would hope that as a field, we would in some way adjust residencies openings in response, rather than the complete opposite.

 

[jupiterianvibe]

Clearly hypofractionation and more selective use of radiation is beneficial to patients and is the future of our field. I would hope that as a field, we would in some way adjust residencies openings in response, rather than the complete opposite.

check to see who is funding ASTRO and what their business model is. Follow the money.

The CAP pushes pathology residency expansion even though our job market is ass because privately owned megacorporations want to recruit cheap pathologist labor to profit from and these corporations are CAPs biggest revenue source

 

[OTN]

check to see who is funding ASTRO and what their business model is. Follow the money.

The CAP pushes pathology residency expansion even though our job market is ass because privately owned megacorporations want to recruit cheap pathologist labor to profit from and these corporations are CAPs biggest revenue source

It’s not quite as obvious in radonc as path, as we don’t have huge megacorps like Quest, but unfortunately each radonc dept chair has individual financial incentive to expand.

 

[scarbrtj]

This forum is inhabited by a rowdy but doughty group. No one can argue it isn't information-rich. But is it information-rich à la The New York Review of Books, or à la Infowars.com? Like Fox News says: we report, you decide.

I had very wealthy fellow call me yesterday asking if he should invest a half million dollars in some company I've never heard of making some "mold" (patient? fungal? baking?) for novel use in proton therapy. He's a smart guy, but not a doctor; protons seem very sexy, very new, very happening. Yes? There's something about cancer... about radiation... that can pull the wool over the less-than-informed folks' eyes. It's a thing. This is at least partly how the chairs and our academic leaders have been "successful" (for their ends: expansion, in all its tangible and intangible forms) for so long. Sort of a tulip mania thing, I reckon. Let a little money out of the balloon, and I foresee a collapse. If not, great! If so, like I said: we reported. Y'all decided.

 

[deleted947887]

I can certainly pledge never to hire a graduate from one of these programs or west virginia, arkansas, penn state.

If private practices boycotted hiring academic rad oncs in general, the same way academic rad oncs treat private practice rad oncs, things would change. It also makes the most sense. By working for an academic center, you're helping kill the specialty through your support of unbridled residency and satellite expansion. It should be an unwritten rule. If you work for an academic center as faculty, it makes you tainted. No jobs after graduation? Do locums.

 

[medgator]

If private practices boycotted hiring academic rad oncs in general, the same way academic rad oncs treat private practice rad oncs, things would change. It also makes the most sense. By working for an academic center, you're helping kill the specialty through your support of unbridled residency and satellite expansion. It should be an unwritten rule. If you work for an academic center as faculty, it makes you tainted. No jobs after graduation? Do locums.

Locums is a way to get your foot in the door at some practices for when a ft job opens up

 

[OTN]

If private practices boycotted hiring academic rad oncs in general, the same way academic rad oncs treat private practice rad oncs, things would change. It also makes the most sense. By working for an academic center, you're helping kill the specialty through your support of unbridled residency and satellite expansion. It should be an unwritten rule. If you work for an academic center as faculty, it makes you tainted. No jobs after graduation? Do locums.

I’d rather hire and experienced PP radonc for our private practice than an experienced academician anyway. Different set of skills, broader base of knowledge needed/gets cultivated as a general PP radonc.

Very much agree with locums to get your foot in the door. Being a great locums for a practice is valuable.

 

[medgator]

I’d rather hire and experienced PP radonc for our private practice than an experienced academician anyway. Different set of skills, broader base of knowledge needed/gets cultivated as a general PP radonc.

Some (in fact many) academics will freely admit that once you specialize to 1 or 2 sites, it is difficult to start treating other sites after a few years

 

[RickyScott]

If private practices boycotted hiring academic rad oncs in general, the same way academic rad oncs treat private practice rad oncs, things would change. It also makes the most sense. By working for an academic center, you're helping kill the specialty through your support of unbridled residency and satellite expansion. It should be an unwritten rule. If you work for an academic center as faculty, it makes you tainted. No jobs after graduation? Do locums.

Please let me qualify what I said. There are already enough residency openings for all applicants, so trainees are making a poor decision by attending one of these new programs when all of them have every opportunity to enroll in an established program. I dont think I am being unfair from this standpoint.

With academic faculty, a lot of them did not have choices for a specific geographic location given life circumstances, or because that was the only job offer they received, (Personally, this was my case.) I would never advocate holding academics against someone. Increasingly, most jobs are now "academic," in name. Junior faculty are more affected by unchecked residency expansion than anyone else in the job market, other than graduating residents. They cant really speak out, even if most would like to, (although, there are some who are just plain sychophants)

 

[KHE88]

Please let me qualify what I said. There are already enough residency openings for all applicants, so trainees are making a poor decision by attending one of these new programs when all of them have every opportunity to enroll in an established program. I dont think I am being unfair from this standpoint.

I must have missed the part during the residency application process where I got to check the box next to the one program I wanted to "enroll in."

I'm sorry, this drum you keep beating is ridiculous. There are myriad valid reasons a highly capable rad onc may end up graduating from a lesser known program. And how are you going to differentiate the grads from the big programs that expanded? In determining which of the 5 graduating PGY-5s are worthy of an interview, how are you going to pick out the 3 who occupied the established spots vs. the 2 who got the inappropriately expanded slots? Maybe the chair will send the rank list to you? Or should we just keep going by USMLE step 1 scores 10 years later?

 

[deleted950463]

I must have missed the part during the residency application process where I got to check the box next to the one program I wanted to "enroll in."

I'm sorry, this drum you keep beating is ridiculous. There are myriad valid reasons a highly capable rad onc may end up graduating from a lesser known program. And how are you going to differentiate the grads from the big programs that expanded? In determining which of the 5 graduating PGY-5s are worthy of an interview, how are you going to pick out the 3 who occupied the established spots vs. the 2 who got the inappropriately expanded slots? Maybe the chair will send the rank list to you? Or should we just keep going by USMLE step 1 scores 10 years later?

To be fair, an expanded stanford or MSKCC residency spot is still more competitive than a new, no name small residency program.

 

[KHE88]

To be fair, an expanded stanford or MSKCC residency spot is still more competitive than a new, no name small residency program.

That wasn't my point, at all. I thought this was obvious, but the individual I was replying to wants to punish residents who train at new programs by making it difficult for them to find jobs. There are two problems with this:

1. Some highly qualified individuals may choose to go to a lesser known program because they are from that region, have family there, and perhaps want to stay in that region after they graduate. Some highly qualified individuals may end up at lesser known programs due to the somewhat random and subjective nature of the interview and match process. Would you rather hire someone who wanted to be a rad onc so bad that he ranked literally every program in the country vs. someone who only wanted to train in a big city and only ranked those programs and applied to radiology or IM as a backup?
2. This doesn't address the perhaps bigger problem of well-known established programs in already extremely competitive local markets expanding spots. Given the choice, I'd rather see a new program in an underserved region vs. an expanded spot at a NYC program. But maybe that's just me.

 

[RickyScott]

That wasn't my point, at all. I thought this was obvious, but the individual I was replying to wants to punish residents who train at new programs by making it difficult for them to find jobs. There are two problems with this:

1. Some highly qualified individuals may choose to go to a lesser known program because they are from that region, have family there, and perhaps want to stay in that region after they graduate. Some highly qualified individuals may end up at lesser known programs due to the somewhat random and subjective nature of the interview and match process. Would you rather hire someone who wanted to be a rad onc so bad that he ranked literally every program in the country vs. someone who only wanted to train in a big city and only ranked those programs and applied to radiology or IM as a backup?
2. This doesn't address the perhaps bigger problem of well-known established programs in already extremely competitive local markets expanding spots. Given the choice, I'd rather see a new program in an underserved region vs. an expanded spot at a NYC program. But maybe that's just me.

This is the worst specialty for an applicant with geographic restrictions. If they need to train in a new program because of family in the region, they are totally in the wrong field right now (and why i wouldnt apply )
You dont have to rank any of the new programs to still be guaranteed a match! Many of these new programs are not in underserved regions: stony broook/LIJ- nyc, philadephia, miami, or within 2 hour drive. Lastly, no reason to believe those who train in the few new programs located in underserved areas will actually stay there. In fact, one or 2 classes of residents will saturate those areas.

 

[deleted950463]

That wasn't my point, at all. I thought this was obvious, but the individual I was replying to wants to punish residents who train at new programs by making it difficult for them to find jobs. There are two problems with this:

1. Some highly qualified individuals may choose to go to a lesser known program because they are from that region, have family there, and perhaps want to stay in that region after they graduate. Some highly qualified individuals may end up at lesser known programs due to the somewhat random and subjective nature of the interview and match process. Would you rather hire someone who wanted to be a rad onc so bad that he ranked literally every program in the country vs. someone who only wanted to train in a big city and only ranked those programs and applied to radiology or IM as a backup?
2. This doesn't address the perhaps bigger problem of well-known established programs in already extremely competitive local markets expanding spots. Given the choice, I'd rather see a new program in an underserved region vs. an expanded spot at a NYC program. But maybe that's just me.

When people with jobs threaten to withhold jobs because someone went to a new program, it’s the symptom of a far larger problem. It’s essentially the same as people in pathology who would only hire from MGH or equivalent.

Your field is sick. Any DO or FMG who graduated from random Kansas DO or IMG filled family medicine residency can find a job in Manhattan, and I don’t mean Manhattan Kansas.

Too many radonc grads.

 

[KHE88]

This is the absolute worst specialty for an applicant with geographic restrictions. If they need to train in a new program because of family in the region, they are in the wrong field right now (and why i wouldnt apply)
You dont have to rank any of the new programs to still be guaranteed a match!. Many of new programs are not in underserved regions stony broook/lij- nyc, philadephia miami, or within 2 hour drive. Lastly, no reason to believe those who train in "underserved" areas will stay there. In fact, one or 2 classes of residents will saturate those areas.

So you would fault an applicant from Arkansas who grew up in Arkansas, went to medical school in Arkansas, and has a family in Arkansas for ranking Arkansas #1 or even at all? The individual in my example with the geographic restriction was the one who only ranked rad onc programs in big cities and ranked radiology or IM as a backup due to a geographic restriction of being in a big city. What's wrong with a person from a small town preferring to stay at the local program, even if new, but ultimately being willing to go anywhere? You're making it seem like this person is a scab, and that's not really fair. And you still haven't addressed the logical fallacy of how to handle the grads in expanded spots at established programs.

I think you're kidding yourself if you think that your method is going to make the tiniest impact in solving this problem and if it does anything it may deny you the opportunity from meeting an otherwise fantastic future partner. Judge people based on their aptitude and character.

 

[KHE88]

When people with jobs threaten to withhold jobs because someone went to a new program, it’s the symptom of a far larger problem. It’s essentially the same as people in pathology who would only hire from MGH or equivalent.

Your field is sick. Any DO or FMG who graduated from random Kansas DO or IMG filled family medicine residency can find a job in Manhattan, and I don’t mean Manhattan Kansas.

Too many radonc grads.

I agree that our field is sick, and I agree that petty hiring practices are a symptom of that. We certainly have major issues with academic elitism and nepotism. But otherwise I have no idea what you are talking about or what point you are trying to make.

 

[thecarbonionangle]

Rumour has it that Case Western is expansing program. Confirm, deny, discuss.

 

[PhotonBomb]

if true (haven't heard this), they couldn't even fill last year in Match 2019, lol at them being able to fill in this climate, let alone in an expansion.

 

[thecarbonionangle]

if true (haven't heard this), they couldn't even fill last year in Match 2019, lol at them being able to fill in this climate, let alone in an expansion.

Birds suggest at interviews they stated going from 6 to 7 and the goal is 8. Highly inappropriate. Chair is VP of NRG, probably sees no problem with it too

 

[PhotonBomb]

Birds suggest at interviews they stated going from 6 to 7 and the goal is 8. Highly inappropriate. Chair is VP of NRG, probably sees no problem with it too

Case is not a good Rad Onc program at all.

Similar to BCM in that way - great med school, lots of good residency programs, historically established, but just a BAD program

Hate to see them try and expand, but will lead to them having even more unfilled spots !

 

[thecarbonionangle]

There are a lot of very piss poor programs. People should continue to call them out. Especially an already BAD program with zero faculty didactic involvement has ZERO business expanding. Any program where faculty refuse to lecture residents should be shut down. We will continue to call these places out here