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What if we made the hats and showed up wearing it at ASTRO. wouldn't that be funny? JKMROGA.. 2020!
What if we made the hats and showed up wearing it at ASTRO. wouldn't that be funny? JKMROGA.. 2020!
I have to say, I just re-read some of the initial posts in the FAQ pinned at the top of this forum from a decade ago, and it's really interesting to see that not much has changed. The small job market has always been the one downside to this field. Credit to GFunk who really is a legend of this forum IMO.
one thing that I think is different, the 2012 starting salary numbers he quotes - salaries are a bit higher now than that, as would be expected I suppose with inflation.
Good that these posts are pinned there for posterity, to sort of knock some sense into those who are enjoying the sky is falling posts. Some of these posters are genuine in their concern and there are real issues to talk about of course. Some other posters just like to troll and/or see the world burn, and thus post nonsensical posts. They know who they are. Some of them are very smart.
I have to say, I just re-read some of the initial posts in the FAQ pinned at the top of this forum from a decade ago, and it's really interesting to see that not much has changed. The small job market has always been the one downside to this field.
It's gotten worse. The recent published data supports that as well as the subjective things many of us are seeing
The fact that you think the gradual doubling in residency slots in a decade has not changed the job market is absurd. It's actually been quite a change to those of us who took a job a decade ago.
Not untrue, but none of us were responsible for randomly doubling residency slots in a decade, and driving down the quality of applicant to this field.While residency expansion and draconian board exams don't help, they are not the real problem with our field. The real problem is that we have lost our curiosity about our oncology. We just grind out phase III trials looking at small changes in dose/field and noting small changes in outcome. We are incrementalists.
We should Partner with vendors, partner with pharma, get a carbon ion center, play with FLASH... we need try some crazy stuff and see what sticks. The students we want to recruit are not the ones who are looking to cash in on their 260+ step one scores. The students we want to recruit should be the ones that want to work on the cool projects that we have already started.
It's not Wallner or Kachnic that are the source of the problem with the dipping applicant numbers, it is the rest of us. Before you start calling Wallner and Kachnic names, ask yourself what you have done to inspire the next class of rad oncs. We all own this.
. The job markets across all of medicine has changed in the last 15 years due to corporitization of hospital systems taking over and buying out all the previously private guys. This has affected all fields. Urology, ENT, Rad Onc, Optho - none untouched.
This is a major factor on the loss of autonomy and income potential to a physician, but is not specific in any way to rad onc.
We should Partner with vendors, partner with pharma, get a carbon ion center, play with FLASH... we need try some crazy stuff and see what sticks.
That data was posted in one of these threads very recently. I believe the last match was at 200 positions offered and the recent nadir was around 2007-8 at ~110.We keep saying 'double' but would also love it if we had exact numbers for number of residency slot in 2009, 2010, 2019, and 2019
When I started residency in the early 2000s there were 90 something and when I left there were around 110
90s didn't have academic satellites. That's a recent phenomenon.Forgot how low spots went after the awful job market in the early to mid 90s but yes it was double digits after all the program closures and adding the extra year of residency in.
We could really use that type of academic leadership again.
We keep saying 'double' but would also love it if we had exact numbers for number of residency slot in 2009, 2010, 2019, and 2019
It'd be nice if we had another chart during the same period of time for total number of 3d/imrt fractions billed to CMS....
90s didn't have academic satellites. That's a recent phenomenon.
Not exactly what you asked for but shows a clear trend to hypofractionationIt'd be nice if we had another chart during the same period of time for total number of 3d/imrt fractions billed to CMS....
Definitely agree with your post about raising profile - but to be fair this is exactly what is kind of being looked at in recent research? like weird examples to pick. FLASH if anything is getting too much attention for how early in proof level it is.
It would be near impossible to get a radiation question alone trial (dose escalation or comparing fractionation schemes) through the NRG right now. Everything is about adding in an immunotherapy drug. Which is good and bad, because there are still radiation alone questions that would be nice to be able to answer. But everything has become about drugs. You got to add a drug somewhere in there to get a trial through.
the newest NRG lung trial is adding in immunotherapy to chemoRT for limited SCLC
What is our alternative to an immune therapy trial for SCLC?... 45 Gy at 1.5 Gy BID vs. 66 Gy at 2Gy qd? The CONVERT trial could have been designed 30 years ago. Immune therapy is clever and novel... std vs. altered fractionation is not.
Where are the trials testing how the newest radio-sensitivity gene panel informs dose eslcalation/de-eslcalation? Where is the data on which fractionation best enriches TCR repertoire? 3rd, 4th, 5th generation radiosensitizers/protecters? Best sequence of RT and targeted therapies? Synthetic lethality? Heavy ion RTCs? Chemo/targeted therapy + heavy ions? etc...
FLASH may work, and it may not... but it is certainly an interesting interesting and novel idea. My point is that we should have ten FLASH-like projects matriculating through the NRG.
I once had a mentor in medical school who would always ridicule residents who failed to follow up on important clinical questions... he would say "Dr. Smith, you are suffering from a startling lack of curiosity". That's us in a nut shell... and even if prospective residency spots were cut in half and the passing rates on boards doubled overnight, this would remain our fields greatest challenge.
It may be the leadership's fault that finding jobs has been harder than it should be for us new grads... but it is not their fault that ASCO is infinitely more relevant than ASTRO... that falls on us.
It may be the leadership's fault that finding jobs has been harder than it should be for us new grads... but it is not their fault that ASCO is infinitely more relevant than ASTRO... that falls on us.
What is our alternative to an immune therapy trial for SCLC?... 45 Gy at 1.5 Gy BID vs. 66 Gy at 2Gy qd? The CONVERT trial could have been designed 30 years ago. Immune therapy is clever and novel... std vs. altered fractionation is not.
Where are the trials testing how the newest radio-sensitivity gene panel informs dose eslcalation/de-eslcalation? Where is the data on which fractionation best enriches TCR repertoire? 3rd, 4th, 5th generation radiosensitizers/protecters? Best sequence of RT and targeted therapies? Synthetic lethality? Heavy ion RTCs? Chemo/targeted therapy + heavy ions? etc...
FLASH may work, and it may not... but it is certainly an interesting interesting and novel idea. My point is that we should have ten FLASH-like projects matriculating through the NRG.
I once had a mentor in medical school who would always ridicule residents who failed to follow up on important clinical questions... he would say "Dr. Smith, you are suffering from a startling lack of curiosity". That's us in a nut shell... and even if prospective residency spots were cut in half and the passing rates on boards doubled overnight, this would remain our fields greatest challenge.
It may be the leadership's fault that finding jobs has been harder than it should be for us new grads... but it is not their fault that ASCO is infinitely more relevant than ASTRO... that falls on us.
Varian, IBA, Hitachi... to say nothing of pharma. Not saying it is easy to get funding, but we have to do a much better job of selling our utility.Let us know where that fountain of funding will come from, since Bristol and Merck have plenty for mo trials
Hitachi? Are they even still in the business?Varian, IBA, Hitachi... to say nothing of pharma. Not saying it is easy to get funding, but we have to do a much better job of selling our utility.
US is falling way behind on Carbon Ions. The Japanese, Chinese, Europeans leaving us in the DUST! Meanwhile we stuck on protons convinced there's a benefit. Can't find it!!!! SAD. I know for a FACT (can't say more) that multiple institutions are burying their own data on protons. We drowning in our own corruption. VERY SAD.
We found that hypofractionated particle irradiation is feasible and may be safe.
Agree. We have multiple local and regional locums contact info, which allows us to avoid those agencies altogether. Seems like a different situation now than a few years ago.For whatever it's worth, I just opened an email from CancerCarePoint (staffing agency) listing large swaths of dates and state licensures for 15(!) different docs needing locums jobs. This email came complete with this line: We have many more candidates with availability.
It doesn't quite have the same impact on this site because the greatly enlarged font size didn't carry over. But yes, bolded, underlined, enlarged... many more.
I've never received such an email before and typically it's the exact opposite, i.e. staffing agencies begging me to work locums. Just another data point for those reading.
I usually see emails listing lots of locums gigs, not mentioning lots of candidates available to provide locums coverage. I think that is what Mandelin rain was getting at, and I would agreeWait - so they list 15(!) docs needing people and say we have many other candidates with availability - and you’re taking that to mean that they are telling you they have many other people looking to locum so you better strike while the iron is hot? That doesn’t really seem to make sense.
It makes more sense that they’re saying ‘and we have other people we work with too that are looking for locums, lots of spots, contact us we have jobs for you!’
Which ones makes more sense for a recruiter who is spam emailing you?
Could be wrong but I think you misinterpreted that
You are wrong. They listed 15(!) locums docs who are out of work. In need of a job. Willing to travel. They stated they have many more unemployed docs in the same boat. They are searching for locums positions to match all (15(!) + many more) these unemployed docs in. Positions that the market used to have in excess.Wait - so they list 15(!) docs needing people and say we have many other candidates with availability - and you’re taking that to mean that they are telling you they have many other people looking to locum so you better strike while the iron is hot? That doesn’t really seem to make sense.
It makes more sense that they’re saying ‘and we have other people we work with too that are looking for locums, lots of spots, contact us we have jobs for you!’
Which ones makes more sense for a recruiter who is spam emailing you?
Could be wrong but I think you misinterpreted that
People... people who need people... are the luckiest people in the world...Wait - so they list 15(!) docs needing people
Correct. Why should I go through an agency when a retired partner is a known quantity and cheaper? Win, win for both partiesoh got it - my mistake.
So it seems like the strategy of just choosing to be a locums person doesn't seem to be as attractive, since there are lots of retired docs trying to do the same?
I do believe, yes, it's probably just a bunch of old farts taking over the locums market. More rad oncs produced, more rad oncs into practice... ergo more retired rad oncs. If I can't get my false teeth to stay in and get my lumbago to settle down I'll probably be right there with those guys. They're drinking the new grads' locums milkshake.*oh got it - my mistake.
So it seems like the strategy of just choosing to be a locums person doesn't seem to be as attractive, since there are lots of retired docs trying to do the same?
You are wrong. They listed 15(!) locums docs who are out of work. In need of a job. Willing to travel. They stated they have many more unemployed docs in the same boat. They are searching for locums positions to match all (15(!) + many more) these unemployed docs in. Positions that the market used to have in excess.
Re: hi tier residency. Word of advice- dont overestimate benefit of hi tier residency on the arc of your career, It certainly may help you land a dream job at a satellite in a major coastal city. But what then? 35-40 year career ahead of you. After 2-5 years, you will have difficulty getting a raise, and very limited mobility given the oversupply. At that point, and moving forward, the tier of your residency really wont matter. From other threadthis stuff is scary. I have decided to double apply high tier rad onc and IM
I decided to by a high-tier stock in the mid-90's: Netscape.this stuff is scary. I have decided to double apply high tier rad onc and IM
For whatever it's worth, I just opened an email from CancerCarePoint (staffing agency) listing large swaths of dates and state licensures for 15(!) different docs needing locums jobs. This email came complete with this line: We have many more candidates with availability.
It doesn't quite have the same impact on this site because the greatly enlarged font size didn't carry over. But yes, bolded, underlined, enlarged... many more.
I've never received such an email before and typically it's the exact opposite, i.e. staffing agencies begging me to work locums. Just another data point for those reading.
If I had to criticize the field, right now I think I would cite “the narcissism of small differences”. of course, when more large centers are pushing protons for prostate and start lying about outcomes like Nancy ... we will be on our way to Trump uYes, Trump University Was a Massive Scam | National Review
Many people believe that higher education is a de facto scam. Trump University, Donald Trump’s real-estate institution, was a de jure one. First thing first, Trump University was never a university…www.google.com
Radiation Oncology=Trump University
If I had to criticize the field, right now I think I would cite “the narcissism of small differences”. of course, when more large centers are pushing protons for prostate and start lying about outcomes like Nancy from UF... we will be on our way to Trump u