It's sad. It's out there that the job market is poor - everyone here knows my refrain. But people will always make decisions in their best interest only and our field does not have a strong enough central body, or compassion enough for new trainees, to overcome this.
3 of those programs are in desirable areas that would fill with someone under except the most extreme of conditions. The chairs of Sinai, Cornell and Stony Brook know this - and it's a simple business decision to check some backs, fund a residency spot, and get cheap labor for 4 years. No matter medicare or institutional funded, there is no employee that is as economically advantageous as a resident. Particularly when case logs are anonymous, easy to meet, there is no real brachy requirements, and the 'education' component can be signing into a lecture online given by another university.
Case and OHSU bit more surprising, but its the same calculus - if they find someone, it benefits their department economically far more than an NP, PA, or any other 'physician extender', and for any of these programs if their graduates don't find jobs, pursue a fellowship, or get squeezed into poor positions - who cares? Who gets punished? The applicant gets punish, the institution still made out like a bandit. And by virtue of having a small field, the people making the decisions retain the power. Just think of the absurdity of Stony Brook expanding - they know what the job market is, they know how the field is going, but their self interest trump all so why not do it? What punishment do they get - mean posts from us? We are the miscreants of the field, of course, just spouting lies and inconveniently highlighting the published data. Even if an applicant goes through and then doesn't find a job - what is his or her recourse against one of these programs? Any speaking up is met with repercussions - less vouching to future employers, cut off from alumni networks. I mean as a program how could you not expand? You are virtually invincible. And ASTRO and SCAROP accommodate this because, SCAROPs needs are best served as well! They sure aren't losing. Their departmental budgets sure aren't losing with this strategy.
You have to appreciate the craziness of the situation. We, me - we are the bad people. We are the bad mouthers, who distort things and try to bring down the #Radoncrocks crowd. But in 2019, after a published overtraining waaaay back in 2015, with hypofract, APM in mind, you have academic radiation oncologists who have enjoyed a better career than probably anyone coming into the field will now enjoy saying 'you know what, my faculty need more notewriters, let's slap another residency slot in there, the ACGME and residency review committee don't really care as long as we check a few minimal boxes, it'll be cheaper than a PA, and if that applicant doesn't get a job we can force him or her into a fellowship afterward'. It's like all regard for data goes out the window in terms of treating junior members of this field. Love the absurdity of it. Happy Holidays!
