Make Your Prediction Here!

[PhotonBomb]

How many spots will go unfilled in the match?

I'm guessing a solid 70.

programs that previously relied on their location that are shi*tty departments to train (Baylor, City of Hope, NY Methodist etc) are gonna get hit hard, these guys aren't used to it.

Make your number guess below!

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[Chartreuse Wombat]

55

#120in2020RadOncNRMP

I figure some will drop their quota so the total positions will fall from 211 to about 175

 

[medgator]

80*






- Could be lower if there aren't as many horror stories from APM and the PGY-5 "hunger games" job search next year. I'd wager at least 50 if there isn't pandemonium regarding the above by March 2020

 

[RadOncDoc21]

If this is like price is right... I’ll say only “1”

 

[PhotonBomb]

Not price is right rules. Closest wins.

 

[Mandelin Rain]

#120in2020

 

[RadOncDoc21]

I see programs ranking more just so they don’t have to SOAP and be called out... my number is still 1. I hope I’m wrong!

 

[randomname2018]

70.

A number of sources have reported a significant reduction in applications this year relative to last year. Programs did not adjust appropriately last year and it isnt clear that they have taken steps to do so this year. I anticipate a number of middle and lower tier programs will go unmatched but also some notable upper tier programs as well.

I'd also predict that we'll see reports of match violations after interview season begins. Details will be vague purposefully. PDs are going to be under increased pressure to match and we may see some resort to bending or breaking the rules to do it.

 

[FrostyHammer]

45-50

 

[Sushirolls]

4

 

[thecarbonionangle]

Half or more of the programs need to be shut down because they are not worth a damn and they don't have any good leadership or education. This is really quite simple. Pay attention folks!

 

[metallica81788]

Half or more of the programs need to be shut down because they are not worth a damn and they don't have any good leadership or education. This is really quite simple. Pay attention folks!

~50

Unfortunately 30ish will be filled in SOAP by the type of programs mentioned above that "need" resident coverage to work.

 

[bachiraki]

As Rad onc has become less competitive in the last few years, applicants are not applying as broadly as they were in the past. Though individual programs are reporting less number of applications this year, I guess overall applicant pool including IMGs, & DOs would be close to 200. Moreover programs are extending interviews generously and are going to rank more. So, we might have a surprise in March, 2020.

I hope I am wrong...

 

[RickyScott]

As Rad onc has become less competitive in the last few years, applicants are not applying as broadly as they were in the past. Though individual programs are reporting less number of applications this year, I guess overall applicant pool including IMGs, & DOs would be close to 200. Moreover programs are extending interviews generously and are going to rank more. So, we might have a surprise in March, 2020.

I hope I am wrong...

I agree.Programs will just take anybody, and then will boast about “diversity” of experience of entering class. some on twitter still post about how barrier to entry to radonc (gap year and board scores) is too “stressful”despite that everyone knows there are more spots than applicants. Total gaslighting and I expect more at match time.

heard that evilboyas mom applying. She got a pub and was on the cover of a magazine.

https://southpark.cc.com/blog/2015/08/18/fan-question-whats-the-episode-with-crack-*****-magazine

 

[bachiraki]

As per google spreadsheet, Duke is interviewing 60-70 for 3 spots. Example of Programs trying hard to match...

 

[fiji128]

#62 unmatched spots on Match Monday. Maybe 30 of those will fill via the Soap later in the week. With all the negative publicity about this field I think its going to be a really hard sell for the PDs to fill. Even if you didn't match who wants to spend 4 years training for a job they may or may not be there. Do people who don't match into their first/second choice specialities ever just blindly Soap into open Pathology spots? I wouldn't think so and I think same would apply to rad onc.

 

[deleted1002574]

50ish "good spots", let's say 60.

* 150 US MD applicants, maybe 90 are gung ho rad onc, rest are double applying.
* 50 "other" (FMG, DO, etc) -, maybe 20 viable

So, 60 for sure get filled, then the 30 or so other gung ho rad oncs - maybe 20 match to a "lesser" program and 10 have to attempt SOAP, b/c they ranked poorly. Half of those SOAP into a spot. 10 of 20 "other" SOAP in.

60+20 +5+10 = 95

Could be ~100.

That's my rough, pessimistic look at things.

 

[medgator]

As per google spreadsheet, Duke is interviewing 60-70 for 3 spots. Example of Programs trying hard to match...

Not unheard of even when it was a lot more competitive last decade

 

[metallica81788]

Not unheard of even when it was a lot more competitive last decade

Anywhere from 12-25 per spot depending on number of spots and program seemed to be the rate 5-6 years ago.

 

[medgator]

Anywhere from 12-25 per spot depending on number of spots and program seemed to be the rate 5-6 years ago.

I remember going to CC when they had 3-4 dates, paid for your hotel etc, but still interviewed like 40-50 people at least for just 2 spots

 

[scarbrtj]

Real match numbers 2014 vs 2019 (incl SOAP)

 

[RadOncDoc2k19]

50ish "good spots", let's say 60.

* 150 US MD applicants, maybe 90 are gung ho rad onc, rest are double applying.
* 50 "other" (FMG, DO, etc) -, maybe 20 viable

So, 60 for sure get filled, then the 30 or so other gung ho rad oncs - maybe 20 match to a "lesser" program and 10 have to attempt SOAP, b/c they ranked poorly. Half of those SOAP into a spot. 10 of 20 "other" SOAP in.

60+20 +5+10 = 95

Could be ~100.

That's my rough, pessimistic look at things.

Curious - what programs make up these 50-60 coveted spots?

 

[medgator]

Curious - what programs make up these 50-60 coveted spots?

Harvard, mdacc, mskcc, Penn, UCSF, uwash, CCF, umich, off the top of my head

 

[thecarbonionangle]

What are the programs that are known to offer bad clinical training to their residents? I’m talking weaknesses in important areas (brachy, sbrt, srs etc). Please post them and put them on blast

 

[PhotonBomb]

What are the programs that are known to offer bad clinical training to their residents? I’m talking weaknesses in important areas (brachy, sbrt, srs etc). Please post them and put them on blast

Yale is one.

 

[bluebubbles]

Yale is one.

But you'll come out with 50 publications! That no one will ever read.

 

[elementaryschooleconomics]

Yale is one.

Their seniors get contracts by like, September of their PGY-5 year though.

The way things are looking, I'd go to a department in rural Alaska where my elective time is wrestling grizzly bears to protect local livestock if it meant I'd get a job offer at the end of it.

I predict 50 unmatched, 25 filled by SOAP.

 

[Church of Radiontology]

Specificity in criticism could help applicants discern between an institutional reputation (that probably has more to do with the university as a whole) and the reality of training within the department.

Program X is weak because . . . .
Its residents don't get sufficient training in . . . .
I've encountered recent graduates who wish they had been taught . . . .

Thematically related Kiwi perspective on complaints vs. criticisms

 

[KHE88]

What are the programs that are known to offer bad clinical training to their residents? I’m talking weaknesses in important areas (brachy, sbrt, srs etc). Please post them and put them on blast

I would flat out avoid any program with > 6 months of mandatory "research."

Med students foolishly think more research time is automatically a good thing. Especially the lazy ones who think of it as some sort of vacation.
For most people, it's not a good thing.

The "research" time off is typically filled with either churning out pointless retrospective papers to bolster the attendings promotion or else you are basically just left on your own to do whatever you want and end up doing nothing. It takes a very motivated academic-track resident to actually benefit from a full year out of clinic.

For most of us, that time is better spent in clinic seeing and managing as many patients as possible.

Are you evaluating your own plans, doing all your own contours, managing all of your own on treatment toxicities, following up all the studies you are ordering, constantly running the list with the nurse and attending, etc.? Or are you just mindlessly writing notes, putting in orders, and seeing inpatients with no clue what's going on behind the scenes? Or worse just shadowing the physician and doing nothing at all? There are "cush" residencies like this where you basically do nothing for 4 years. And people want to go there? You really going to be comfortable practicing on your own when you finish?

Remember, the goal here is to prepare you for practice. Not to make your attendings' jobs easier or to chill at the beach. Extended time off for "research" is not going to better prepare ~90% of residents for practice. They think it's a good thing, when in reality they are being used.

I took a solo job with no other rad onc for hundreds of miles as my first job out of residency and people think I'm frickin nuts. I might be a little nuts, fine, but I think if your residency didn't prepare you to practice on your own without constant help your first year, they failed you.

 

[deleted1002574]

Very good point, re: research year. Usually just wasted time.

In addition to what he says, places that have a "continuity clinic" or 6 months as senior where your patients are your own (basically) are good training for real life.

 

[scarbrtj]

I took a solo job with no other rad onc for hundreds of miles as my first job out of residency and people think I'm frickin nuts. I might be a little nuts, fine, but I think if your residency didn't prepare you to practice on your own without constant help your first year, they failed you.

Newly minted gen surgeons would do stuff like this all the time (not sure 'bout now w/ hours restrictions etc). Once you've done 50 cholecystectomies on your own you feel comfortable with it. Gen surgeons even have a saying, "You'll never be as smart as you are on your last day of residency." There was a brief time period when rad oncs were getting fully board certified (written and oral) before graduating. Producing an equivocating invertebrate jelly unable to make treatment decisions, no matter the specialty, is bad for society.

 

[deleted1002574]

I took a solo job with no other rad onc for hundreds of miles as my first job out of residency and people think I'm frickin nuts. I might be a little nuts, fine, but I think if your residency didn't prepare you to practice on your own without constant help your first year, they failed you.

What kind of peer review do you have ? I always wondered what it would be like in solo practice like that.

 

[KHE88]

What kind of peer review do you have ? I always wondered what it would be like in solo practice like that.

None. We are not accredited. I think in the past we were accredited and there was some remote review with a private clinic a few hours away, but it was mainly box checking from what I understand.

Not ideal, but there are lots of unideal things that you just have to deal with when the alternative is the patients just go without any treatment at all.

 

[scarbrtj]

Their seniors get contracts by like, September of their PGY-5 year though.

The way things are looking, I'd go to a department in rural Alaska where my elective time is wrestling grizzly bears to protect local livestock if it meant I'd get a job offer at the end of it.

I predict 50 unmatched, 25 filled by SOAP.

not sure if I'm reading tea leaves correctly but in 2018 weren't there 18 filled by SOAP? So 25 would not be all that big of an increase?

 

[elementaryschooleconomics]

Newly minted gen surgeons would do stuff like this all the time (not sure 'bout now w/ hours restrictions etc). Once you've done 50 cholecystectomies on your own you feel comfortable with it. Gen surgeons even have a saying, "You'll never be as smart as you are on your last day of residency." There was a brief time period when rad oncs were getting fully board certified (written and oral) before graduating. Producing an equivocating invertebrate jelly unable to make treatment decisions, no matter the specialty, is bad for society.

This sort of goes along with SDN's general feelings re: the radbio/physics exams, but there needs to be an increasing acknowledgement in our specialty that we're approaching (or have surpassed) a time where memorizing trivia is not very important. With smartphones and the internet, I can access virtually the sum total of human knowledge regarding radiation therapy, and can access practicing experts within a matter of hours (either through a personal network, the Mednet, email, phone call, etc).

We're simultaneously very similar and dissimilar to surgeons. With surgeons, a wrong cut can almost instantly kill a person, and muscle memory/practical experience is very important. With us, a wrong contour can simply be erased and corrected. It can edited and refined quickly and easily until the physician is satisfied.

I think being trained at a place where the curtain is pulled back and the WHY of things is explained, not just the HOW, is among the most important skills. If you understand why something is done, you can translate that knowledge to a situation that you've never seen before. If you log 500 cases during residency, but are intimately involved in the treatment planning of every case, you are better trained than someone who logs 1000 cases by just drawing a GTV and handing it off to a crack team of dosimetrists, then the next thing you know the patient is on-beam.

Instead of taking radbio/physics exams, I would much rather have a "practical" exam during residency where we're given rare cases to treat which few people have ever seen, but are allowed to access any and all resources we know about. The resident would then be graded on how effectively they used resources and their decision making process along the way.

I might be totally crazy, I know.

But to bring it back to what we're talking about...raw case numbers are more important for surgeons than RadOnc (obviously...you need to see hundreds of cases, lol), but look for environments where you're involved in all aspects of treating a patient with radiation.

 

[Krukenberg]

This sort of goes along with SDN's general feelings re: the radbio/physics exams, but there needs to be an increasing acknowledgement in our specialty that we're approaching (or have surpassed) a time where memorizing trivia is not very important. With smartphones and the internet, I can access virtually the sum total of human knowledge regarding radiation therapy, and can access practicing experts within a matter of hours (either through a personal network, the Mednet, email, phone call, etc).

We're simultaneously very similar and dissimilar to surgeons. With surgeons, a wrong cut can almost instantly kill a person, and muscle memory/practical experience is very important. With us, a wrong contour can simply be erased and corrected. It can edited and refined quickly and easily until the physician is satisfied.

I think being trained at a place where the curtain is pulled back and the WHY of things is explained, not just the HOW, is among the most important skills. If you understand why something is done, you can translate that knowledge to a situation that you've never seen before. If you log 500 cases during residency, but are intimately involved in the treatment planning of every case, you are better trained than someone who logs 1000 cases by just drawing a GTV and handing it off to a crack team of dosimetrists, then the next thing you know the patient is on-beam.

Instead of taking radbio/physics exams, I would much rather have a "practical" exam during residency where we're given rare cases to treat which few people have ever seen, but are allowed to access any and all resources we know about. The resident would then be graded on how effectively they used resources and their decision making process along the way.

I might be totally crazy, I know.

But to bring it back to what we're talking about...raw case numbers are more important for surgeons than RadOnc (obviously...you need to see hundreds of cases, lol), but look for environments where you're involved in all aspects of treating a patient with radiation.

Bad idea to get rid of rad bio and physics. It’s a barrier to entry for other specialties trying to do what we do. If you want to protect rad onc jobs then ultimately it’s a bittersweet pill to swallow.

 

[elementaryschooleconomics]

Bad idea to get rid of rad bio and physics. It’s a barrier to entry for other specialties trying to do what we do. If you want to protect rad onc jobs then ultimately it’s a bittersweet pill to swallow.

Yeah, fair.

I just have this dream that we're assessed on how we do our job, not remembering that XRCC1 is involved in single strand break repair. That doesn't change management in daily practice...

 

[scarbrtj]

This sort of goes along with SDN's general feelings re: the radbio/physics exams, but there needs to be an increasing acknowledgement in our specialty that we're approaching (or have surpassed) a time where memorizing trivia is not very important. With smartphones and the internet, I can access virtually the sum total of human knowledge regarding radiation therapy, and can access practicing experts within a matter of hours (either through a personal network, the Mednet, email, phone call, etc).

We're simultaneously very similar and dissimilar to surgeons. With surgeons, a wrong cut can almost instantly kill a person, and muscle memory/practical experience is very important. With us, a wrong contour can simply be erased and corrected. It can edited and refined quickly and easily until the physician is satisfied.

I think being trained at a place where the curtain is pulled back and the WHY of things is explained, not just the HOW, is among the most important skills. If you understand why something is done, you can translate that knowledge to a situation that you've never seen before. If you log 500 cases during residency, but are intimately involved in the treatment planning of every case, you are better trained than someone who logs 1000 cases by just drawing a GTV and handing it off to a crack team of dosimetrists, then the next thing you know the patient is on-beam.

Instead of taking radbio/physics exams, I would much rather have a "practical" exam during residency where we're given rare cases to treat which few people have ever seen, but are allowed to access any and all resources we know about. The resident would then be graded on how effectively they used resources and their decision making process along the way.

I might be totally crazy, I know.

But to bring it back to what we're talking about...raw case numbers are more important for surgeons than RadOnc (obviously...you need to see hundreds of cases, lol), but look for environments where you're involved in all aspects of treating a patient with radiation.

Agree 100; reflects "real life." Soapbox... To take "crazy" even further, I would train residents to plan (beam choice, arc choice, understand the TPS, fuse the images and transfer from DICOM), optimize, transfer to R&V, and QA a plan (obviously with close dosimetry/physics help and input) for several cases early in their career. This truly involves one in "all aspects" of treating a patient with radiation. For most cases, once the decision of treating and a dose is decided upon, it's the planning choices that will influence clinical outcomes. Once you do this enough times it creates a beneficial loop where the toxicity/outcome results you see in clinic (which dosimetrists and physicists do not see) can be fed back into the TPS decision processes.

 

[elementaryschooleconomics]

Agree 100; reflects "real life." Soapbox... To take "crazy" even further, I would train residents to plan (beam choice, arc choice, understand the TPS, fuse the images and transfer from DICOM), optimize, transfer to R&V, and QA a plan (obviously with close dosimetry/physics help and input) for several cases early in their career. This truly involves one in "all aspects" of treating a patient with radiation. For most cases, once the decision of treating and a dose is decided upon, it's the planning choices that will influence clinical outcomes. Once you do this enough times it creates a beneficial loop where the toxicity/outcome results you see in clinic (which dosimetrists and physicists do not see) can be fed back into the TPS decision processes.

Man I could not agree more.

 

[evilbooyaa]

I would flat out avoid any program with > 6 months of mandatory "research."

Med students foolishly think more research time is automatically a good thing. Especially the lazy ones who think of it as some sort of vacation.
For most people, it's not a good thing.

The "research" time off is typically filled with either churning out pointless retrospective papers to bolster the attendings promotion or else you are basically just left on your own to do whatever you want and end up doing nothing. It takes a very motivated academic-track resident to actually benefit from a full year out of clinic.

For most of us, that time is better spent in clinic seeing and managing as many patients as possible.

Are you evaluating your own plans, doing all your own contours, managing all of your own on treatment toxicities, following up all the studies you are ordering, constantly running the list with the nurse and attending, etc.? Or are you just mindlessly writing notes, putting in orders, and seeing inpatients with no clue what's going on behind the scenes? Or worse just shadowing the physician and doing nothing at all? There are "cush" residencies like this where you basically do nothing for 4 years. And people want to go there? You really going to be comfortable practicing on your own when you finish?

Remember, the goal here is to prepare you for practice. Not to make your attendings' jobs easier or to chill at the beach. Extended time off for "research" is not going to better prepare ~90% of residents for practice. They think it's a good thing, when in reality they are being used.

I took a solo job with no other rad onc for hundreds of miles as my first job out of residency and people think I'm frickin nuts. I might be a little nuts, fine, but I think if your residency didn't prepare you to practice on your own without constant help your first year, they failed you.

I pretty strongly disagree with this. The students bright enough to get into rad onc over the past 5-10 years do not need 4 (or 3.5) years of clinical rad onc to become a competent clinician. It can be done in 3 years quite comfortably. Why not have a year where you can chill, prep for boards, and have good quality of life? Sure, you may also get some research done (if you want to go for academics) that will be mostly useless as a resident, especially if it's clinical, but this residency used to be 3 years of clinical education and that was more than sufficient.

There's a difference between confidence and hubris.

I agree that the bolded above is important, but the two points are not mutually exclusive.

I'm not sure what running the list means in a rad onc clinic as that is an inpatient thing.

If we're going to be like surgeons and say case numbers are all that matter and therefore residents shouldn't get any research time, then that logic must also go to say that all residents should be double covering attendings so as to get the maximum number of volume.

I wish I could've just graduated residency a year earlier, but if they're going to force me to be there for 4 years, I'm going to spend a year of it doing clinical research rather than being stuck in clinic.

 

[KHE88]

I pretty strongly disagree with this. The students bright enough to get into rad onc over the past 5-10 years do not need 4 (or 3.5) years of clinical rad onc to become a competent clinician. It can be done in 3 years quite comfortably. Why not have a year where you can chill, prep for boards, and have good quality of life? Sure, you may also get some research done (if you want to go for academics) that will be mostly useless as a resident, especially if it's clinical, but this residency used to be 3 years of clinical education and that was more than sufficient.

There's a difference between confidence and hubris.

I agree that the bolded above is important, but the two points are not mutually exclusive.

I'm not sure what running the list means in a rad onc clinic as that is an inpatient thing.

If we're going to be like surgeons and say case numbers are all that matter and therefore residents shouldn't get any research time, then that logic must also go to say that all residents should be double covering attendings so as to get the maximum number of volume.

I wish I could've just graduated residency a year earlier, but if they're going to force me to be there for 4 years, I'm going to spend a year of it doing clinical research rather than being stuck in clinic.

That's fine, and I understand where you're coming from as a resident as I had some similar thoughts previously, but the issue is you don't know what you don't know when you're a resident, and I've had a learn a lot and struggle to fill in some gaps. Your time in training is valuable and importantly, PROTECTED, meaning you've got somebody watching your back (or you should anyway). 3 years of rad onc may have been sufficient in the 1980s, but it's complicated now. It can probably be done in 3 years, but when you break it up with a year of research, you're doing a real disservice, as continuity is crucial for skill development and knowledge retention. You don't want to be out on your own trying to treat an SBRT pancreas when the last time you saw one was as a PGY-3 because you did a year of research as a PGY-4 then did mostly breast and prostates and a PGY-5.

Especially if your goal is to "chill" as a resident. That's not the point of residency. That's for later. Your point about wasting time studying for boards is well taken, though.

The "research" time off is a huge waste for the vast majority of residents and we all know it. I had 6 months, and it was a brain drain for me. I can't imagine losing a continuous year doing chart reviews then trying to go out and practice.

 

[evilbooyaa]

Radiation Oncology is like riding a bike. If I hadn't SBRT'd a pancreas since PGY-3 and was asked to do it as a first year attending, I wouldn't have the hubris to do it without re-reviewing the literature and the process. I haven't treated a GBM in over 2 years, but do I know what I would do for it as a first year attending? Of course.

I agree with you that there is an element of nerves for a brand new attending, as there is no attending oversight. I have not personally lived that so I will defer to you on that. That being said, treating 50 early stage breasts or 500 is not going to change my confidence, if I'm working in-depth on all 50 of those (how to evaluate a plan, FiF vs Wedge, beam angles, mean heart dose, etc.). I am cognizant that this is resident dependent. Similar thing with prostate (especially intact).

 

[KHE88]

I'm not sure what running the list means in a rad onc clinic as that is an inpatient thing.

My point exactly. These are not things you are thinking about as a resident when you are busy writing notes, cranking out research papers, and switching services every 2-3 months.

When you run a clinic by yourself, you have to be responsible and keep tabs on every issue with every patient that has been treated, seen, consulted, sent for second opinions/further studies, under treatment, or in follow-up mode. Usually residents aren't even involved in this. A lot of times residents are not properly trained in IGRT, or understand how to order and review imaging and make game time decisions during treatment based on imaging because they are not reviewing imaging with the attending at the end of the day every day, just as an example.

 

[Church of Radiontology]

If a Holman Pathway MD/PhD can get trained with as few as 27 months in clinic (as permitted by the ACGME and the ABR), on what basis do mere MDs need 36 months in clinic (minimum)?

Especially in the era of milestones-based evaluations, there should be a mechanism for residents leaving early if they have met their minimum case numbers.

 

[medgator]

If a Holman Pathway MD/PhD can get trained with as few as 27 months in clinic (as permitted by the ACGME and the ABR), on what basis do mere MDs need 36 months in clinic (minimum)?

Especially in the era of milestones-based evaluations, there should be a mechanism for residents leaving early if they have met their minimum case numbers.

Rad Onc was a 3 year residency until the 90s, when it was extended by a year, in part, to address the crappy job market. I guess that is what fellowships are kinda doing now, postponing graduates hitting the market

 

[OTN]

Required research:
I was forced to do 12 months of basic science research in residency. Wasn't allowed to be clinical. I hated every second of it, and at the end of it all my PI gave the authorship to one of his assistants rather than me. Swell. Would have much rather been allowed to finish early. Training program implemented this after I was already there, so nothing I could do.

Boards:
- Physics boards make a ton of sense. I found value in understanding enough to be able to communicate with my physicists, and from time to time physics knowledge does help with treatment planning and clinical decision-making.
- Biology boards make zero sense and are a tremendous waste of time and resources. Every single specialty deals with the biology of their diseases and their treatments. All of them. None other than ours makes their residents take biology boards. It makes us look insecure as a specialty and intellectually weak, as it's patently obvious that making residents take an exam about something as broad as the "biology of cancer" is ridiculous. As the biology boards do seem to serve as a jobs program for radbio faculty, however, I doubt this will change.

 

[Church of Radiontology]

Here's my proposal.

1. Make rad onc a 3-year residency again, keeping the same case number requirements as presently. Departments could make graduation contingent upon passage of physics and radbio, if they wanted.

2. Physics, radbio, and clinical written exams can be taken at any point in training, in any order.

3. One is not eligible for the oral boards until after passing all written exams and completion of one year post-residency practice, from which a case list must be submitted. (There is precedent for this in other fields.)

In essence, this would change the current PGY5 year of residency (dominated by senioritis, research electives, and underutilized skills) into a year of productive employment with deserved responsibility and autonomy. This year could be a fellowship--or it could be direct employment. Departments dependent upon resident labor would therefore be incentivized to deliver demonstrable educational and professional value to their graduates (PGY5s)--or else they'd just leave. Furthermore, as PGY5 "fellows", RO trainees would be permitted to have much more real responsibility and autonomy in patient care while still benefiting from some amount of oversight and back-up. (Medicare treats a PGY5 rad onc resident in the 48th month of oncology training as a resident, whereas a PGY4 heme-onc fellow in the first month of oncology training can bill for services. Go figure.)

Staying for a PGY5 fellowship at one's training institution wouldn't be such a bad deal if it were accompanied by increased autonomy commensurate with one's training (no need to get attendings to bless OTVs for billing purposes), a salary bump, and a competitive marketplace.

Thoughts? (I know it's not going to happen.)

 

[gmsquid]

[QUOTE="KHE88, post: 21378462, member: 925266]

Are you evaluating your own plans, doing all your own contours, managing all of your own on treatment toxicities, following up all the studies you are ordering, constantly running the list with the nurse and attending, etc.? Or are you just mindlessly writing notes, putting in orders, and seeing inpatients with no clue what's going on behind the scenes? Or worse just shadowing the physician and doing nothing at all? There are "cush" residencies like this where you basically do nothing for 4 years. And people want to go there? You really going to be comfortable practicing on your own when you finish?

Remember, the goal here is to prepare you for practice. Not to make your attendings' jobs easier or to chill at the beach.
[/QUOTE]

I’ll tell you, it’s amazing how few residents do these things. I worked my butt off in residency doing these things and when I became an attending the adjustment was minimal. I’m keenly aware of other people who trained at reputable places who spend the first year flailing. The real danger isn’t the first year though. The problem is you’re struggling to do things without somebody’s watch so you may not even be doing it right. Then you never break bad habits. That’s really the key to residency, Try to manage everything while learning from your mistakes when they still don’t matter.

 

[medgator]

Time to see who came closest.... Can anyone with access to the data post the total number of unfilled spots (total with and without pgy1 included)

 

[radonconogs]

21 programs, 30 spots in total