M1 - need advice please

[verstalews34]

Current M1 considering rad onc! I need some advice on how to choose what to pursue – considering rad onc or something surgical at the moment.

After working in rad onc for ~5 years in college at an academic center, I've fallen in love with the field. While working, I started doing research voluntarily with faculty and got multiple pubs. I learned a lot about clinical research and I know those skills will pay dividends if/when I pursue research in another field. It also seems like matching in rad onc is "significantly easier at the moment", from what some rad oncs have told me. While the job market is pretty saturated, it seems like wages have remained pretty stagnant? Can anyone discuss this?

I'm curious what both what made you choose (or not choose) rad onc, and when that decision was made. Also, any tips/ideas or thoughts would be greatly appreciated. Thanks!

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[Fpg1245]

Current M1 considering rad onc! I need some advice on how to choose what to pursue – considering rad onc or something surgical at the moment.

After working in rad onc for ~5 years in college at an academic center, I've fallen in love with the field. While working, I started doing research voluntarily with faculty and got multiple pubs. I learned a lot about clinical research and I know those skills will pay dividends if/when I pursue research in another field. It also seems like matching in rad onc is "significantly easier at the moment", from what some rad oncs have told me. While the job market is pretty saturated, it seems like wages have remained pretty stagnant? Can anyone discuss this?

I'm curious what both what made you choose (or not choose) rad onc, and when that decision was made. Also, any tips/ideas or thoughts would be greatly appreciated. Thanks!

I feel like you are asking and then answering your own questions. You worked in the field for 5 years and you’ve never used the forum or head of it. What do you think you are going to get out of this forum?

 

[deleted1116990]

You can search this forum easily and find that almost everyone here is going to recommend you do something else. But sure, let's beat a dead horse...

If you can get into surgery and stomach the residency, then do that. Not everyone can (myself and a lot of people here who went into a field like rad onc for that reason), and that's OK. But you should aim to try and figure this out by your 3rd year of med school.

Rad onc is a great field with easy hours, but you will severely limit your career flexibility. With regards to what you will be able to earn and where you will be able to live, who knows. You're a decade out from your first job. Our world will be vastly different by then if the past decade is any indicator. Whereas, if you go into ortho it is still a very safe bet even with a decade of unknown developments in front of us to say you should be able to live where you want and earn in the top 10% of physicians. If you can't stomach surgery, then rule out other more lifestyle friendly fields like gas, derm, IM subspecialties, etc before you decide to chain yourself to rad onc.

Your career trajectory is largely going to be out of your control in this field. You want to be in a field where the barriers to lateral career changes are minimal, trust me. Rad onc probably has the most barriers in this regard than any other field in medicine, and there is little to suggest that it will do anything but get worse in the future.

 

[Ray D. Ayshun]

The good news is that you've picked the least competitive field in medicine, so there's no rush in making your decision. You can start the ass kissing process late third year if you decide on this.

 

[dieABRdie]

I chose it because I love working with cancer patients. I can't see doing anything else. I think surgery is deathly boring... and I hate hematology. It was the end of M2 for me, so pretty easy decision.

If you actually like surgery; then do surgery... no question. Personally I still find it boring, so my choice going back would be med onc.... as I still can't see myself doing anything except treating cancer patients. The community outpatient world is nothing like inpatient academics; which I did not know until I was out actually practicing. Indications for novel systemic therapies are exploding.

Now.... if I had to RETRAIN AGAIN, I would probably do combined IR/DR as it would complement the current skillset. With the explosion of novel therapies there is also an explosion of imaging to accompany it. But most importantly.. I would have a procedural skill that can't be legislated away to a midlevel or part-time locums doc. You know.... kind of like a surgeon?

 

[TheWallnerus]

If you have fallen in love with the field, you should do rad onc. I remember in Beauty and the Beast thinking, “How could Belle ever choose the Beast… he’s so ugly.” Bittersweet and strange… But once Belle had made her choice, that was that. And now that I’m older I realize that if someone REALLY wants something, no person can make them not want that thing.

 

[elementaryschooleconomics]

It's October of your M1 year.

From your story, it sounds like you're ready to marry the first person you kissed in middle school.

Get through med school and the 75 other rotations first.

Sow wild oats.

 

[deleted1111261]

Specialty promiscuity through medical school will let you have true passion in the field you choose to "be the one", a love that endures

 

[Gfunk6]

 

[thecarbonionangle]

Is this the rad onc “leaders” chairs, who previously did not give a rats arse about minorities, chasing them while frothing at the mouth like walking dead zombies? Of course it is, this is america!

Seriously run and never look back. Abandon all hope, all ye who enter here.

 

[theradiator]

Is this the rad onc “leaders” chairs, who previously did not give a rats arse about minorities, chasing them while frothing at the mouth like walking dead zombies? Of course it is, this is america!

Seriously run and never look back. Abandon all hope, all ye who enter here.

Took a quick look at the ASTRO abstracts this year and can assure you that the future is bleak.

 

[thecarbonionangle]

Took a quick look at the ASTRO abstracts this year and can assure you that the future is bleak.

Pretty underwhelming i agree. The most “interesting” one is the peds cincinati 8x1 proton FLASH one and that ain’t saying much!

 

[Ray D. Ayshun]

Took a quick look at the ASTRO abstracts this year and can assure you that the future is bleak.

What's new in breast?

 

[Gfunk6]

Took a quick look at the ASTRO abstracts this year and can assure you that the future is bleak.

Here is a blurb of the first keynote speaker:

• Professor, Department of African American Studies, Director of Graduate Affairs, Princeton University.
• Specializes in interdisciplinary study of science, medicine, and technology; race-ethnicity and gender; knowledge and power.
• Author of People’s Science: Bodies and Rights on the Stem Cell Frontier (Stanford University Press 2013), Race After Technology (Polity 2019).
• Editor of Captivating Technology: Race, Carceral Technoscience, and Liberatory Imagination in Everyday Life (Duke University Press 2019), as well as numerous articles and book chapters.
• Talk will discuss the themes outlined in Race After Technology, including the social dimensions of data science, discriminatory design in technology, and how digital tools can replicate existing hierarchies and propagate racist policies.

Obviously all essential and timely concerns of our field.

 

[deleted1116990]

Here is a blurb of the first keynote speaker:

• Professor, Department of African American Studies, Director of Graduate Affairs, Princeton University.
• Specializes in interdisciplinary study of science, medicine, and technology; race-ethnicity and gender; knowledge and power.
• Author of People’s Science: Bodies and Rights on the Stem Cell Frontier (Stanford University Press 2013), Race After Technology (Polity 2019).
• Editor of Captivating Technology: Race, Carceral Technoscience, and Liberatory Imagination in Everyday Life (Duke University Press 2019), as well as numerous articles and book chapters.
• Talk will discuss the themes outlined in Race After Technology, including the social dimensions of data science, discriminatory design in technology, and how digital tools can replicate existing hierarchies and propagate racist policies.

Obviously all essential and timely concerns of our field.

Rad onc is not unique in being held hostage by the intersectionality grifters. This has permeated every field and industry and will continue until corporations and organizations take a stand at the peril of outcry from the cancel-mob. It would be unrealistic to expect ASTRO to be one of the first to do this. It's hard to fault them for going through the necessary appeasement motions as it's a systemic sickness in society. There's plenty of other very legitimate things to fault them for that they can control, though.

 

[deleted1111261]

How did the entire society feel that this isn’t divisive ?

 

[theradiator]

What's new in breast?

Took a quick look at the ASTRO abstracts this year and can assure you that the future is bleak.

Concurrent boost for breast, non-inferiority
4 Gy for orbital lymphoma, single arm
Hypofractionated RT for high risk prostate, non-inferiority
Proton FLASH 8 Gy X 1 palliative

Apparently trying to improve outcomes is no longer needed for an ASTRO plenary.

And on the very next page, the Mayo Clinic 3 fraction breast trial!

 

[thecarbonionangle]

Concurrent boost for breast, non-inferiority
4 Gy for orbital lymphoma, single arm
Hypofractionated RT for high risk prostate, non-inferiority
Proton FLASH 8 Gy X 1 palliative

Apparently trying to improve outcomes is no longer needed for an ASTRO plenary.

And on the very next page, the Mayo Clinic 3 fraction breast trial!

Translation: less fractions.
SIB in breast will be declared SOC. Sequential boost=grift
Boom boom SOC
Proton 8x1 SOC.
Prostate hypofrac for high risk? Been SOC where have you been?!

 

[deleted1111261]

At least SIB is IMRT ?

Or “IMRT”. Can never tell.

 

[thecarbonionangle]

I think one of the problems is careerism. So many “academics” just publish trash fluff. The low hanging fruit is noninferiority and fraction reduction. You do 5 fx APBI? I can do 3, with protons! next someone does one fraction. It is the easiest thing to do when you have to publish. Another grift is publish same article 5 times in different journals and say the same thing. The field is circling the toilet. This is a total snoozer ASTRO year in a terrible location.

 

[deleted1111261]

I think one of the problems is careerism. So many “academics” just publish trash fluff. The low hanging fruit is noninferiority and fraction reduction. You do 5 fx APBI? I can do 3, with protons! next someone does one fraction. It is the easiest thing to do when you have to publish. Another grift is publish same article 5 times in different journals and say the same thing. The field is circling the toilet. This is a total snoozer ASTRO year in a terrible location.

Puffy tacos are bomb

 

[RickyScott]

5 vs 3 fractions just captures everything wrong with this field.

 

[Radonky]

I think one of the problems is careerism. So many “academics” just publish trash fluff. The low hanging fruit is noninferiority and fraction reduction. You do 5 fx APBI? I can do 3, with protons! next someone does one fraction. It is the easiest thing to do when you have to publish. Another grift is publish same article 5 times in different journals and say the same thing. The field is circling the toilet. This is a total snoozer ASTRO year in a terrible location.

When promotion depends on quantity >>>>> quality, the game is played, and almost all academic institutions are like this.

 

[medgator]

When promotion depends on quantity >>>>> quality, the game is played, and almost all academic institutions are like this.

 

[Fpg1245]

Oh look there’s my chair talking!

 

[thecarbonionangle]

Oh look there’s my chair talking!

Missing from this is the sycophant boot lickers slurping it up saying “yes boss!” telling them the merde tastes and smells good. Plenty of these folks in my residency and current department.

 

[Chartreuse Wombat]

Missing from this is the sycophant boot lickers slurping it up saying “yes boss!” telling them the merde tastes and smells good

boot lickers/throne sniffers

 

[Fpg1245]

Missing from this is the sycophant boot lickers slurping it up saying “yes boss!” telling them the merde tastes and smells good. Plenty of these folks in my residency and current department.

Don’t forget about impressionable med students who hang of their every word as they vie for LORs!!

 

[Ray D. Ayshun]

Anyway, welcome to the field. Fwiw, I drive a Dodge Stratus.

 

[thesauce]

Anyway, welcome to the field. Fwiw, I drive a Dodge Stratus.

Those are sick

 

[deleted1111261]

Anyway, welcome to the field. Fwiw, I drive a Dodge Stratus.

I used to drive a dodge stratus

Now a Toyota Camry hybrid

 

[CurbYourExpectations]

maybe if this job analysis is of any merit you'll have an answer before you'll need to choose

 

[Gfunk6]

maybe if this job analysis is of any merit you'll have an answer before you'll need to choose

LOL, I can save you time. The analysis is going to read something like this: "There have been many concerns raised about the job market for RO given the expansion of residency programs and number of residents as well as accelerating hypofractionation. We have concluded that there is cause for concern and are recommending that a committee be formed so that this issue can be thoroughly analyzed with appropriate solutions for current and future stakeholders. Regardless, we believe that it is critically important to focus our recruitment on under-represented groups including people of color and LBGTQ+."

That's it. Now give me my $50,000 consultation fee.

 

[Doctorer]

LOL, I can save you time. The analysis is going to read something like this: "There have been many concerns raised about the job market for RO given the expansion of residency programs and number of residents as well as accelerating hypofractionation. We have concluded that there is cause for concern and are recommending that a committee be formed so that this issue can be thoroughly analyzed with appropriate solutions for current and future stakeholders. Regardless, we believe that it is critically important to focus our recruitment on under-represented groups including people of color and LBGTQ+."

That's it. Now give me my $50,000 consultation fee.

Don't be ridiculous.

I guarantee ASTRO is spending more than $50k.

 

[deleted1111261]

LOL, I can save you time. The analysis is going to read something like this: "There have been many concerns raised about the job market for RO given the expansion of residency programs and number of residents as well as accelerating hypofractionation. We have concluded that there is cause for concern and are recommending that a committee be formed so that this issue can be thoroughly analyzed with appropriate solutions for current and future stakeholders. Regardless, we believe that it is critically important to focus our recruitment on under-represented groups including people of color and LBGTQ+."

That's it. Now give me my $50,000 consultation fee.

This is it. Guaranteed

 

[fiji128]

As long as I am acknowledged as a stakeholder, that all I really ever wanted.

 

[CurbYourExpectations]

No faith in Chirag?

 

[fiji128]

I’ll withhold judgement until it’s published. I’m not super optimistic that the data won’t be messaged in a certain way but let’s see what is says.

 

[medgator]

No faith in Chirag?

Too many boomers and boomer inertia to fight

 

[NotMattSpraker]

maybe if this job analysis is of any merit you'll have an answer before you'll need to choose

There is supposed to be prelim data presented at ASTRO, anyone get their abstract books yet from Red?