Physics & Radbio

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The job market would concur.

Slots should be cut back to 110-120 asap

Yes, let's cut the residency slots by 50% immediately! You're such a one note poster. You have no idea what's going on, but good to see that you think the test should be weeding people out, you must write for the ABR.


By the way - can we all stop acting like recalls had ANYTHING to do with the low pass rate this year? It's totally and completely irrelevant. You can't in one moment say that the test was out of left field and unlike past tests and what our expectations were (a TRUE statement) and then also bring up recalls. You know what a Recall is? ASTRO tests and Hall. THe test didn't ask what they usually do. Recalls would have helped ZERO.


There's SO MUCH nonsense being posted here that it's ruining the picture. Get a hold of yourselves, people. Let go of the anger, have a simple point of view, and have reasonable expectations. The test was unreasonably hard for rad bio this year, we deserve to know what the pass rate was, and they need to fix how they determine the passing rate. That's it. You're not taking the test early this year, you're not going to win a lawsuit. Stop with the nonsense. What you should be asking for is more transparency from the ABR in all accounts - including what the pass rates were. SO if you know it, spit it out.
 
Yes, let's cut the residency slots by 50% immediately! You're such a one note poster. You have no idea what's going on, but good to see that you think the test should be weeding people out, you must write for the ABR.
Quit trolling (didn't say a single thing about the test) and start facing the facts when you finally do get board certified....
 
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As an aside, I actually think it would be a GOOD idea to pivot toward cancer biology and new agents, as we deal with these drugs on a daily basis with our patients. It seems incredibly unlikely that future advances in the field of radiation oncology will come from novel fractionation or other classical radiobiological means. Rather, the fight to improve outcomes is very likely to come from continuously improving systemic agents and finding the best way to integrate radiotherapy with those treatments.

That being said, to completely switch the content of the exam in one year with no warning is absurdity. It's a shame and its a failure on the part of the ABR. One more strike against our academic overlords...
 
Regarding the recall issue, I disagree for reasons already noted. It's not like 100% of the test was these new detailed molecular biology questions. They comprised a surprisingly large portion of the test, but there were still SOME regular questions. You really didn't have any room to miss any of these if the molecular bio stuff took you by surprise. Cheating with recalls would give you a clear advantage here, moreso than in past years IMO (certainly not "ZERO") because the new molecular bio crap dumped everybody precipitously closer to the cut score. RO2019, you can feel free to PM me.

Regarding pivoting the field towards cancer biology, this is a separate issue. It is controversial whether we should shift our focus in both research and resident education from technological advances in delivery and imaging to cancer biology. I personally agree that it does make sense to educate more from a cancer biology standpoint (to a limited degree -- the detail we saw on the exam was ridiculous). The issue here was that this change came out of the blue. If they want to change the rules of the game, they need to tell us. If our coaches have spent 3 years preparing us for a marathon and we show up ready to run and find out at the starting line that we have to compete in 100 meter hurdles instead, that's not really fair.

Regarding the job market issue, stop already. There is a separate thread for that.
 
Quit trolling (didn't say a single thing about the test) and start facing the facts when you finally do get board certified....


I passed boards this year, and the job market seems quite robust this year so far.

and yes - earlier in this thread you bolded and agreed with 'there is no way we went from 130 -> 200 test takers and kept educational standards the same.'

you're old and out of touch, man.
 
I passed boards this year, and the job market seems quite robust this year so far.

and yes - earlier in this thread you bolded and agreed with 'there is no way we went from 130 -> 200 test takers and kept educational standards the same.'

you're old and out of touch, man.
And you're young and naive. Robust if you're looking in rural/Midwest positions.

That wasn't a knock on the residents, and you clearly missed the point of that original post... you think all of those new community/small academic programs had appropriate faculty for teaching?
 
And you're young and naive. Robust if you're looking in rural/Midwest positions.

That wasn't a knock on the residents, and you clearly missed the point of that original post... you think all of those new community/small academic programs had appropriate faculty for teaching?

The s*** job market and s*** radbio exam have nothing to do with each other. I’m sure those of us on this thread looking for answers and action would appreciate it if you would stop trying to make a connection where none exists. Trust me I know of plenty of big academic programs who had failures this year as well.

If in fact this year’s exam was designed to intentionally screw over a lot of us entering the job market then that’s a far bigger/more corrupt problem. But I’m not that conspiratorial and I think the ABR just simply dropped the ball and won’t admit it. But can we please use the job market thread for the job market stuff?


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I think you guys should be aggressive in a respectful way. Send letters and emails to the ABR. Talk to your PDs and ask them to petition on your behalf. I know that it seems like the ABR is an untouchable juggernaut but consider that ABIM was even larger. There are far fewer Rad Oncs than Internists so we don’t need so many of us to demand change and accountability.

Even though I am well past initial certification, I still have to deal with the extortion that is MOC. We are all in this together.
 
And you're young and naive. Robust if you're looking in rural/Midwest positions.

That wasn't a knock on the residents, and you clearly missed the point of that original post... you think all of those new community/small academic programs had appropriate faculty for teaching?


Oh man. This is too good. You cannot be more oblivious. How are you seriously doubling down on this. It had NOTHING to do with expansion or the job market.
 
Agree with this 100%. Also, does the fact that the guy in charge of certification is also vice president of 21st century oncology not bother anyone? It costs less to hire someone who is not certified. Does no one else see this conflict of interest?

Yes I absolutely see this as a conflict of interest. Doesn’t he make enough money with them? Shouldn’t he retire by now?
 
I had a similar experience with Wallner with email exchanges and I had to catch myself from saying something I would regret later so I understand the frustration.

Sadly, as I stated earlier, I don't expect anything to change. My recommendation would be to make your point and move on as time is precious.
 
And you're young and naive. Robust if you're looking in rural/Midwest positions.

That wasn't a knock on the residents, and you clearly missed the point of that original post... you think all of those new community/small academic programs had appropriate faculty for teaching?

Yes, the new community/small academic problems are required to have radiobiology faculty in order to exist. It is completely asinine to suggest, as you and Dr. Wallner are doing, that poor resident performance on rad bio this year was due to incompetent teaching and lax admission standards at these programs and that you can only learn rad bio at MD Anderson (rumor was they didn't have a great pass rate either btw). Yeah, go on and keep attacking the small midwest programs and trying to blame everything on them. Lets shut them down and train everyone in the big coastal programs. That's a great way to fix the maldistribution problem.

This goes back to rad onc eating its young. The older generation, as evidenced by incendiary posts like these, has this idea of "I've got mine, so what? You want to play? Fine, but we'll make the rules harder for you." The different time limits for MOC depending on what year you finished, grandfathering in of old certificates, etc. It's all bogus. If we need to know cellular biology minutae, and you're making recent grads recertify, then make everybody recertify. Wallner should have to recertify and take the rad bio exam too. Unless you don't really need to know that stuff in order to be competent and they are using the exam for another reason besides assessing minimum competence.
 
Yes, the new community/small academic problems are required to have radiobiology faculty in order to exist. It is completely asinine to suggest, as you and Dr. Wallner are doing, that poor resident performance on rad bio this year was due to incompetent teaching and lax admission standards at these programs and that you can only learn rad bio at MD Anderson (rumor was they didn't have a great pass rate either btw). Yeah, go on and keep attacking the small midwest programs and trying to blame everything on them. Let's shut them down and train everyone in the big coastal programs. That's a great way to fix the maldistribution problem.
Or we could just screw everyone with an oversupply of rad oncs by opening up as many programs as possible, which seems to be the way you want to handle this problem (along with the clueless higher ups in academia), without even considering the possibility that the faculty support and case levels don't support all of those new programs (in addition to the finite job market in RO).

Even more asinine.
 
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Guys this thread and the confirmed reports of failures at so many institutions indicates that there was an anomaly with this years Rad Bio test.

The first step is obtaining more information. We need to know what the official pass rate was for the Rad Bio exam this year. It needs to be provided and explained.

For those dismissing this endeavor, realize that mistakes and conflicts of interest definitely occur, just look at NYT article this Sun about top cancer doc at top institution failing to disclose millions of dollars in industry payments. So dont just say suck it up and try again next year. There may have been a serious problem with the exam this year and we need to know what the pass rate was to better evaluate it. Was it 55%, 60% or 70%? All hinges on the pass rate because that could provide the evidence of a serious deviation.
 
Whoever has information in regards to the pass rate, if you worry about posting it online yourself, please feel free to PM me and I will anonymously post it on your behalf. If you are going to send it to me, I would like some form of explanation as to how you obtained it (discussion with PD, e-mail from Wallner, discussion with ABR, etc.). I only require that so I can give some sort of explanation of how reliable the information is. This will all be 100% confidential.

I do agree with those that say the pass rate needs to be posted. I know it sucks as I'm not in the shoes of those who failed, but I do think there isn't a whole lot else that can be done.

@medgator We are all aware of your thoughts on the job market. I request that you discuss the topic at hand (which is the THIS year anomaly of rad bio scores) and not on residency expansion/job market woes in this thread. As others have stated, there are plenty of other threads for that. This is in no way to silence you or your thoughts, but the fastest way to lose focus on a critical issue such as this is to get sidetracked by off-topic conversations.
 
There was an Radiation Biology Task Force that was developed a few years ago, and an executive summary of their findings and recommendations was published in the Red Journal:

Current status and recommendations for the future of research, teaching, and testing in the biological sciences of radiation oncology: report of th... - PubMed - NCBI

It is worthwhile to read the topics mentioned in this document, as it gives some more insight into the rationale on why the test was changed and why the dozen or so old ASTRO study guides suddenly became less relevant this year. There is a section on education and testing, and the proposed areas of scientific concentration seem to correlate with the new exam.

Still no rationale about why they implemented the change (De-emphasizing older classic topics and emphasizing novel never-before-tested ones) without warning to programs about shifting curriculum. And no rationale to explain the ABR's attempt to explain away failures by saying the exam didn't change.
 
Everyone feels for those who failed their boards, but this needs to be reined in.

1. Rumors need to stop. In like 2 pages of posts it has gone from 'this was a totally new unfair test with new concepts' to 'all the big programs use recalls which is rampant cheating' to 'wait... wouldn't it not be congruent for recalls to be effective for an all new test' to 'well recalls would still offer huge payoff to set floor with repeated questions' to '50% of MD Anderson grads failed anyway according to my cousin Danny Devita'.

Anger is justified, but claiming all the big programs cheat is offensive, and I have no personal stake to defend them.

2. Totally justifiable to ask for pass rate, totally ridiculous to speculate. ABR should release, no arguments, but if the fail rate was 50% then I have to say, with about only 10 unique posters here saying they failed, there is a gap. And if its 50% that needs to be examined heavily.

3. Also, the pass rate for physics needs to be posted. There are 2 posts at most complaining about physics. If the pass rate for both exams is low, there is justification in saying that factors related to trainees, how they were taught, what resources they had etc may be the largest factors.

4. To the few posters who have shared they failed rad bio or physics twice, including last year, that stinks and I am sorry, this exam may have been tougher and provided a very tough reprieve, but there may be factors such as test taking strategies, program prep, time per question, which need examination as well. You are not a bad person or less of a physician, but there are factors that caused you to fail twice independent of this years exam.

5. I am not conflating the job market with this exam - in fact I explicitly stated I do not want exams to be used as a weed out tool. But it is justifiable to ask if, in expansion, the educational resources are not what these programs claimed to be. A lot of questions are reported here as being minutae - maybe it is, can't prove it. But at my smaller program we had multiple lectures on basic cell biology and at times even questions. Some people even asked extra questions and exchanged emails and then we subsequently had more lectures. They ended up being helpful. Was their a lack of basic biologic pathway teaching? Lack of time from faculty? Can't say. ALL I can say it is reasonable to examine educational processes when the class size doubles. Stop. End sentence.

6. When there are major events, it is often a confluence of events, such as multiple contributions from all of the above.

7. I called out Wallner for being hypocritical on residency expansion, and provided proof of this by contrasting his published comments from papers 7 years apart. That is fair. You people claiming a Wallner conspiracy are disgusting. I am sorry you failed, heck I don't even like Wallner, but I have a reason and actual evidence of his shifting positions to justify this. Come on, be better.

8. To GFunk and just the general sense that MOC is not worth our time - it is wrong that the older providers were grandfathered in. But the MOC they left us, which I also posted and complained about, is a joke. Kachnic and Wallner have made it far too easy to stay certified, turning it into a color inside the lines type activity instead of actual evaluation of competency which may actually hold said older practitioners to standards becoming of our field / protecting the public. This radbio exam is not a signal to many of us that MOC or certification should be made easier - it is already too east. Would prefer a different body, but do not think everyone who puts in the time effort wants even less oversight of practicing physicians.
 
Everyone feels for those who failed their boards, but this needs to be reined in.

1. Rumors need to stop. In like 2 pages of posts it has gone from 'this was a totally new unfair test with new concepts' to 'all the big programs use recalls which is rampant cheating' to 'wait... wouldn't it not be congruent for recalls to be effective for an all new test' to 'well recalls would still offer huge payoff to set floor with repeated questions' to '50% of MD Anderson grads failed anyway according to my cousin Danny Devita'.

Anger is justified, but claiming all the big programs cheat is offensive, and I have no personal stake to defend them.

2. Totally justifiable to ask for pass rate, totally ridiculous to speculate. ABR should release, no arguments, but if the fail rate was 50% then I have to say, with about only 10 unique posters here saying they failed, there is a gap. And if its 50% that needs to be examined heavily.

3. Also, the pass rate for physics needs to be posted. There are 2 posts at most complaining about physics. If the pass rate for both exams is low, there is justification in saying that factors related to trainees, how they were taught, what resources they had etc may be the largest factors.

4. To the few posters who have shared they failed rad bio or physics twice, including last year, that stinks and I am sorry, this exam may have been tougher and provided a very tough reprieve, but there may be factors such as test taking strategies, program prep, time per question, which need examination as well. You are not a bad person or less of a physician, but there are factors that caused you to fail twice independent of this years exam.

5. I am not conflating the job market with this exam - in fact I explicitly stated I do not want exams to be used as a weed out tool. But it is justifiable to ask if, in expansion, the educational resources are not what these programs claimed to be. A lot of questions are reported here as being minutae - maybe it is, can't prove it. But at my smaller program we had multiple lectures on basic cell biology and at times even questions. Some people even asked extra questions and exchanged emails and then we subsequently had more lectures. They ended up being helpful. Was their a lack of basic biologic pathway teaching? Lack of time from faculty? Can't say. ALL I can say it is reasonable to examine educational processes when the class size doubles. Stop. End sentence.

6. When there are major events, it is often a confluence of events, such as multiple contributions from all of the above.

7. I called out Wallner for being hypocritical on residency expansion, and provided proof of this by contrasting his published comments from papers 7 years apart. That is fair. You people claiming a Wallner conspiracy are disgusting. I am sorry you failed, heck I don't even like Wallner, but I have a reason and actual evidence of his shifting positions to justify this. Come on, be better.

8. To GFunk and just the general sense that MOC is not worth our time - it is wrong that the older providers were grandfathered in. But the MOC they left us, which I also posted and complained about, is a joke. Kachnic and Wallner have made it far too easy to stay certified, turning it into a color inside the lines type activity instead of actual evaluation of competency which may actually hold said older practitioners to standards becoming of our field / protecting the public. This radbio exam is not a signal to many of us that MOC or certification should be made easier - it is already too east. Would prefer a different body, but do not think everyone who puts in the time effort wants even less oversight of practicing physicians.

1. Agreed.
2. Agreed. ABR has no reason to release an 'official' pass rate publicly, which is why I'm soliciting anonymous information from those 'in the know'.
3. I feel that the bigger issue is, anecdotally, with Rad Bio. Most have stated they felt Physics may have been somewhat tricky but otherwise not unreasonable.
4. Won't say much more besides a tough time to have to deal with non-clinically relevant boards.
5. Majority of expansion is more residents per large academic department, not new departments (although there may be an additional 10-20 yearly spots). Do we really think that having more residents per radiobiologist at bigger instititutions is going to worsen outcomes so significantly? If it was just the new programs that were struggling, then so be it, but again, anecdotally, there are failures even at well-established programs.

7. What do you mean by a Wallner conspiracy? Do you mean that Wallner published an editorial stating that the quality of trainees was worsening and then needed some evidence to back up his statement? While certainly not provable, I certainly think that this is not unreasonable. There is no transparency throughout the ABR, and despite whatever issues there were with Rad Bio (in previous years), there was not this level of explosion and discussion over it until this year. Which was conveniently immediately after he wrote an article about how residents in this field were worsening in quality.

I bet clinical boards pass rates this year are unchanged. I bet the clinical boards pass rates next year are unchanged as well.

The link found about how Wallner wanted to have radiation oncologists know translational cancer biology is a good find... for everybody except those who just took it.
 
Pretty sure you need to go back and count the amount of reported failures. And you can add another for Physics.

Program Directors - where are you and what is the plan?

ARRO - can we have an update?

This field is absurd - the lack of guidance, insecurities from above, and goals of making physician scientist alone. The inability of introspection across our field and hidden agendas is disturbing. We are self destructive and driving away good people.

We need the help of ARRO and PDs. Can we somehow find a mechanism to unify? A forum to discuss real-time? Together with the right support we can certainly put fire under the ABR. And I agree colleagues - start writing your letters to editors, journals, and magazines. Be loud. Because the ABR and its leadership has been hard of hearing, and now is the time.





Everyone feels for those who failed their boards, but this needs to be reined in.

1. Rumors need to stop. In like 2 pages of posts it has gone from 'this was a totally new unfair test with new concepts' to 'all the big programs use recalls which is rampant cheating' to 'wait... wouldn't it not be congruent for recalls to be effective for an all new test' to 'well recalls would still offer huge payoff to set floor with repeated questions' to '50% of MD Anderson grads failed anyway according to my cousin Danny Devita'.

Anger is justified, but claiming all the big programs cheat is offensive, and I have no personal stake to defend them.

2. Totally justifiable to ask for pass rate, totally ridiculous to speculate. ABR should release, no arguments, but if the fail rate was 50% then I have to say, with about only 10 unique posters here saying they failed, there is a gap. And if its 50% that needs to be examined heavily.

3. Also, the pass rate for physics needs to be posted. There are 2 posts at most complaining about physics. If the pass rate for both exams is low, there is justification in saying that factors related to trainees, how they were taught, what resources they had etc may be the largest factors.

4. To the few posters who have shared they failed rad bio or physics twice, including last year, that stinks and I am sorry, this exam may have been tougher and provided a very tough reprieve, but there may be factors such as test taking strategies, program prep, time per question, which need examination as well. You are not a bad person or less of a physician, but there are factors that caused you to fail twice independent of this years exam.

5. I am not conflating the job market with this exam - in fact I explicitly stated I do not want exams to be used as a weed out tool. But it is justifiable to ask if, in expansion, the educational resources are not what these programs claimed to be. A lot of questions are reported here as being minutae - maybe it is, can't prove it. But at my smaller program we had multiple lectures on basic cell biology and at times even questions. Some people even asked extra questions and exchanged emails and then we subsequently had more lectures. They ended up being helpful. Was their a lack of basic biologic pathway teaching? Lack of time from faculty? Can't say. ALL I can say it is reasonable to examine educational processes when the class size doubles. Stop. End sentence.

6. When there are major events, it is often a confluence of events, such as multiple contributions from all of the above.

7. I called out Wallner for being hypocritical on residency expansion, and provided proof of this by contrasting his published comments from papers 7 years apart. That is fair. You people claiming a Wallner conspiracy are disgusting. I am sorry you failed, heck I don't even like Wallner, but I have a reason and actual evidence of his shifting positions to justify this. Come on, be better.

8. To GFunk and just the general sense that MOC is not worth our time - it is wrong that the older providers were grandfathered in. But the MOC they left us, which I also posted and complained about, is a joke. Kachnic and Wallner have made it far too easy to stay certified, turning it into a color inside the lines type activity instead of actual evaluation of competency which may actually hold said older practitioners to standards becoming of our field / protecting the public. This radbio exam is not a signal to many of us that MOC or certification should be made easier - it is already too east. Would prefer a different body, but do not think everyone who puts in the time effort wants even less oversight of practicing physicians.
 
Everyone feels for those who failed their boards, but this needs to be reined in.

1. Rumors need to stop. In like 2 pages of posts it has gone from 'this was a totally new unfair test with new concepts' to 'all the big programs use recalls which is rampant cheating' to 'wait... wouldn't it not be congruent for recalls to be effective for an all new test' to 'well recalls would still offer huge payoff to set floor with repeated questions' to '50% of MD Anderson grads failed anyway according to my cousin Danny Devita'.

Anger is justified, but claiming all the big programs cheat is offensive, and I have no personal stake to defend them.

2. Totally justifiable to ask for pass rate, totally ridiculous to speculate. ABR should release, no arguments, but if the fail rate was 50% then I have to say, with about only 10 unique posters here saying they failed, there is a gap. And if its 50% that needs to be examined heavily.

3. Also, the pass rate for physics needs to be posted. There are 2 posts at most complaining about physics. If the pass rate for both exams is low, there is justification in saying that factors related to trainees, how they were taught, what resources they had etc may be the largest factors.

4. To the few posters who have shared they failed rad bio or physics twice, including last year, that stinks and I am sorry, this exam may have been tougher and provided a very tough reprieve, but there may be factors such as test taking strategies, program prep, time per question, which need examination as well. You are not a bad person or less of a physician, but there are factors that caused you to fail twice independent of this years exam.

5. I am not conflating the job market with this exam - in fact I explicitly stated I do not want exams to be used as a weed out tool. But it is justifiable to ask if, in expansion, the educational resources are not what these programs claimed to be. A lot of questions are reported here as being minutae - maybe it is, can't prove it. But at my smaller program we had multiple lectures on basic cell biology and at times even questions. Some people even asked extra questions and exchanged emails and then we subsequently had more lectures. They ended up being helpful. Was their a lack of basic biologic pathway teaching? Lack of time from faculty? Can't say. ALL I can say it is reasonable to examine educational processes when the class size doubles. Stop. End sentence.

6. When there are major events, it is often a confluence of events, such as multiple contributions from all of the above.

7. I called out Wallner for being hypocritical on residency expansion, and provided proof of this by contrasting his published comments from papers 7 years apart. That is fair. You people claiming a Wallner conspiracy are disgusting. I am sorry you failed, heck I don't even like Wallner, but I have a reason and actual evidence of his shifting positions to justify this. Come on, be better.

8. To GFunk and just the general sense that MOC is not worth our time - it is wrong that the older providers were grandfathered in. But the MOC they left us, which I also posted and complained about, is a joke. Kachnic and Wallner have made it far too easy to stay certified, turning it into a color inside the lines type activity instead of actual evaluation of competency which may actually hold said older practitioners to standards becoming of our field / protecting the public. This radbio exam is not a signal to many of us that MOC or certification should be made easier - it is already too east. Would prefer a different body, but do not think everyone who puts in the time effort wants even less oversight of practicing physicians.

Agree with most points. Namely speculation over pass rate (though there seems to be enough universal discontent both here and beyond to presume it’s lower than it’s ever been), and accusations of Wallner conspiracies are out of line. But just because he has no ulterior motive doesn’t mean the ABR didn’t drop the ball by overthinking this exam and that they won’t admit it’s a problem is... a problem.

I have no idea about recalls. Can’t say I know of any program or person who’s benefited from it. But there can be an advantage from recalls and 50% of the exam can also come out of left field. They are not mutually exclusive, obviously. In fact if we presume the left field questions were answered equally among test takers then the recalls become more valuable.

I have zero interest - none - in hearing about educational resources, training, or resident quality or from anyone who did not take this year’s exam. You simply lack the perspective to comment on it, sorry. It’s funny that you are calling out the speculation on here, yet want to suggest that the education/training dropped off which even more speculative.

I am waiting for, and would very much welcome, those who crushed the exam to come on here, tell us to suck it up, and help us figure out what to do to perform better. If you’re out there and don’t want to post publicly please PM me. The fact of the matter is that the people who did well on here say they have some background or a PhD in molecular biology, feel lucky to have passed, and have the same complaints about content as those who did not pass. Same sentiment from those I talked to beyond sdn. I can confirm that failures include people from top 10 programs, w/ MD/PhDs, and w/ 260+ step 1 scores. Really tough sell to make this about anything other than the exam itself.


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Hey DebtRising- I know of one big name program that shares years worth of recall questions.

Bottom line, the ABR failed in updating and sharing appropriate study guides. Setting people up for failure is illegal.

This whole thing would make for a great movie. How will it end?
 
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anytime someone talks about recalls its clear they've totally lost the plot. I hate dense people.
 
Agree with most points. Namely speculation over pass rate (though there seems to be enough universal discontent both here and beyond to presume it’s lower than it’s ever been), and accusations of Wallner conspiracies are out of line. But just because he has no ulterior motive doesn’t mean the ABR didn’t drop the ball by overthinking this exam and that they won’t admit it’s a problem is... a problem.

I have no idea about recalls. Can’t say I know of any program or person who’s benefited from it. But there can be an advantage from recalls and 50% of the exam can also come out of left field. They are not mutually exclusive, obviously. In fact if we presume the left field questions were answered equally among test takers then the recalls become more valuable.

I have zero interest - none - in hearing about educational resources, training, or resident quality or from anyone who did not take this year’s exam. You simply lack the perspective to comment on it, sorry. It’s funny that you are calling out the speculation on here, yet want to suggest that the education/training dropped off which even more speculative.

I am waiting for, and would very much welcome, those who crushed the exam to come on here, tell us to suck it up, and help us figure out what to do to perform better. If you’re out there and don’t want to post publicly please PM me. The fact of the matter is that the people who did well on here say they have some background or a PhD in molecular biology, feel lucky to have passed, and have the same complaints about content as those who did not pass. Same sentiment from those I talked to beyond sdn. I can confirm that failures include people from top 10 programs, w/ MD/PhDs, and w/ 260+ step 1 scores. Really tough sell to make this about anything other than the exam itself.


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Agree, to someone who crushes physics I would love some help. I’m clearly not going to get info from the ABR and it’s not easy to locate a private tutor for radiation physics. At this point I don’t know what I don’t know but still fell short somewhere, even when I thought I was fine. So if you have resources please PM me! I gotta figure this out and would be very grateful.
 
I got a number from the man himself, the physics pass rate was 70%
 
I got a number from the man himself, the physics pass rate was 70%

I would have expected more of an uproar regarding physics with that pass rate. Interesting....
 
I would have expected more of an uproar regarding physics with that pass rate. Interesting....

Right? Also makes me wonder what the rad bio numbers were since there has been a lot more noise about this.
 
This needs a letter to the “failing new york times”. They love xrt articles. They went to town on the UPENN LDR prostate disaster at the VA (guy still there btw). They would love this story.
 
This needs a letter to the “failing new york times”. They love xrt articles. They went to town on the UPENN LDR prostate disaster at the VA (guy still there btw). They would love this story.

Agreed. Writing a letter this weekend. Others should do the same. This is unacceptable and going to detract from our education the remainder of the year.
 
I urge the 100 people that this has harmed to submit a letter to [email protected].

This does not sound like a good idea to me. Anyone thinking that they are going to get support from the general public about this has another thing coming. You can try to explain until you are blue in the face that a significant portion of the material on this exam is not relevant to clinical medicine and it won't matter. The optics won't change. While flawed, it intuitively makes sense that if board exams are hard then we will be left with better doctors. People don't want to think or check facts. All they are going to hear is a bunch of spoiled people in a highly paid field whining that they couldn't pass a test.

If you are going to write letters then focus your efforts on the ABR, Wallner, etc.
 
This does not sound like a good idea to me. Anyone thinking that they are going to get support from the general public about this has another thing coming. You can try to explain until you are blue in the face that a significant portion of the material on this exam is not relevant to clinical medicine and it won't matter. The optics won't change. While flawed, it intuitively makes sense that if board exams are hard then we will be left with better doctors. People don't want to think or check facts. All they are going to hear is a bunch of spoiled people in a highly paid field whining that they couldn't pass a test.

If you are going to write letters then focus your efforts on the ABR, Wallner, etc.

Agreed. This story is totally different from the cheating/recalls story that they ate up.

I think this story would be better received on something like KevinMD.

EDIT: This is also different from the ABIM story, which was going on for years. If this was a longer term issue, we would have more evidence for a corruption story.
 
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This does not sound like a good idea to me. Anyone thinking that they are going to get support from the general public about this has another thing coming. You can try to explain until you are blue in the face that a significant portion of the material on this exam is not relevant to clinical medicine and it won't matter. The optics won't change. While flawed, it intuitively makes sense that if board exams are hard then we will be left with better doctors. People don't want to think or check facts. All they are going to hear is a bunch of spoiled people in a highly paid field whining that they couldn't pass a test.

If you are going to write letters then focus your efforts on the ABR, Wallner, etc.

I think this is right, guys. I believe someone else (RadoncG?) who understood the media a bit was working on developing an organized, simple, consolidated message to news organizations and helping him may be the better way to go. Otherwise it’s difficult to explain the nuance and frankly I agree that people won’t really care unless the big guy vs little guy story is told and told well. This isn’t someone implanting prostate seeds in 100 bladders, this is complaining about an unfair exam. Also, not to doubt the poster but until we have something official from the abr we can’t just say that half the class failed. Even though I’m w/ everyone else, 50/50 does sound hard to believe.

I do think continued communication w/ Wallner/ABR might be productive. We apparently already got him to spill the beans on physics now we need radbio and the overall pass rate.


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Agreed. This story is totally different from the cheating/recalls story that they ate up.

I think this story would be better received on something like KevinMD.

Good point. We do have to find the right audience.
 
I agree wholeheartedly that people should NOT contact the news media. Public surveys show that most people are in strong favor of certification/MOC as they believe (rightly or wrongly) that it ensures physician quality. The public most likely doesn't care about the Angoff method or pass rates. If they learn that the pass rates are suddenly lower, they will simply conclude that the test-takers were not prepared or that the programs they come from are poor quality.
 
Everyone feels for those who failed their boards, but this needs to be reined in.

1. Rumors need to stop. In like 2 pages of posts it has gone from 'this was a totally new unfair test with new concepts' to 'all the big programs use recalls which is rampant cheating' to 'wait... wouldn't it not be congruent for recalls to be effective for an all new test' to 'well recalls would still offer huge payoff to set floor with repeated questions' to '50% of MD Anderson grads failed anyway according to my cousin Danny Devita'.

Anger is justified, but claiming all the big programs cheat is offensive, and I have no personal stake to defend them.

2. Totally justifiable to ask for pass rate, totally ridiculous to speculate. ABR should release, no arguments, but if the fail rate was 50% then I have to say, with about only 10 unique posters here saying they failed, there is a gap. And if its 50% that needs to be examined heavily.

3. Also, the pass rate for physics needs to be posted. There are 2 posts at most complaining about physics. If the pass rate for both exams is low, there is justification in saying that factors related to trainees, how they were taught, what resources they had etc may be the largest factors.

4. To the few posters who have shared they failed rad bio or physics twice, including last year, that stinks and I am sorry, this exam may have been tougher and provided a very tough reprieve, but there may be factors such as test taking strategies, program prep, time per question, which need examination as well. You are not a bad person or less of a physician, but there are factors that caused you to fail twice independent of this years exam.

5. I am not conflating the job market with this exam - in fact I explicitly stated I do not want exams to be used as a weed out tool. But it is justifiable to ask if, in expansion, the educational resources are not what these programs claimed to be. A lot of questions are reported here as being minutae - maybe it is, can't prove it. But at my smaller program we had multiple lectures on basic cell biology and at times even questions. Some people even asked extra questions and exchanged emails and then we subsequently had more lectures. They ended up being helpful. Was their a lack of basic biologic pathway teaching? Lack of time from faculty? Can't say. ALL I can say it is reasonable to examine educational processes when the class size doubles. Stop. End sentence.

6. When there are major events, it is often a confluence of events, such as multiple contributions from all of the above.

7. I called out Wallner for being hypocritical on residency expansion, and provided proof of this by contrasting his published comments from papers 7 years apart. That is fair. You people claiming a Wallner conspiracy are disgusting. I am sorry you failed, heck I don't even like Wallner, but I have a reason and actual evidence of his shifting positions to justify this. Come on, be better.

8. To GFunk and just the general sense that MOC is not worth our time - it is wrong that the older providers were grandfathered in. But the MOC they left us, which I also posted and complained about, is a joke. Kachnic and Wallner have made it far too easy to stay certified, turning it into a color inside the lines type activity instead of actual evaluation of competency which may actually hold said older practitioners to standards becoming of our field / protecting the public. This radbio exam is not a signal to many of us that MOC or certification should be made easier - it is already too east. Would prefer a different body, but do not think everyone who puts in the time effort wants even less oversight of practicing physicians.

So you've taken it upon yourself to rein it in, huh? No offense (alright, a little bit of offense), but you didn't take this year's exam and it doesn't affect you. What you care about is the job market, and you are trying, desperately reaching, to shut this conversation down and make this tangentially about the job market by blaming failures on program complement increases. This is ridiculous.

The recall issue is serious and worthy of discussion, and it frankly pisses me off that people are trying to sweep that under the rug. I never said that only big programs are using recalls and that "all big programs cheat." This is dishonest and a lame strawman argument on your part. I have no idea which programs are systematically using recalls. But it certainly makes sense that it would be easier to do so in programs with 4-5 residents per year rather than ones with 1 resident per year. If programs are using recalls, that creates an un-level playing field. It affects historical pass rates and creates a falsely elevated perception of what we "would know" to the test-makers. The potential use of recalls is of relevance to discussion about this exam in particular due to the difficulty of the new content increasing the importance of not missing the recycled content (as noted by another poster as well). If you're in a program that uses recalls, by all means come here and call them out because they deserve to be called out -- it is NOT ok.

Regarding the Wallner "conspiracy" (again, you are dishonestly jumping to hyperbole to try and make our concerns look silly), I have posted a number of articles authored by Wallner indicating that he wanted to change the content of the exam. I personally am of the opinion that the secretive way in which the exam content was changed was not entirely by chance. I don't know him, have never spoken to the man, and I don't know what his personal opinions are. I just know what he has published in regards to desired changes in the exam content (I would say that counts as "evidence") and a post here where he claimed the content of the exam didn't change. This does not make me, or anyone else scratching their head about this "disgusting" "conspiracy" theorists who usually talk about the moon landing and 9/11.

Yes, the physics pass rate also appears to be low. That doesn't automatically mean that the class of 2019 simply had less cognitive horsepower than the geniuses your year. The rumors need to stop? All this place is a forum for conversation and discussion. By nature it's all rumors since we are all anonymous and not speaking in any official capacity. Might as well shut the whole site down. I hypothsized that the bar for physics was also raised as they expected more failures on bio and it would look bad to have a major deviation on only one exam. A lot easier to just blame the residents and programs then, which is precisely what was done based on the emails posted here.

Most rad onc residents don't post on this forum. This place has been around since what, the late 90s? There have always been some failures every year, but I can't find any posts about a failure on bio and physics until this year, and there are multiple ones. That says something. If you're reading this and failed bio and/or physics, please make an account and share your thoughts. This is about us and what we perceive to be an unfair exam holding us to higher and unreasonable standards than all of our predecessors, not the ABR apologists who keep trying to blame the residents and programs and derail the conversation back to the job market (for like what, the 10th time in this thread?).
 
This does not sound like a good idea to me. Anyone thinking that they are going to get support from the general public about this has another thing coming. You can try to explain until you are blue in the face that a significant portion of the material on this exam is not relevant to clinical medicine and it won't matter. The optics won't change. While flawed, it intuitively makes sense that if board exams are hard then we will be left with better doctors. People don't want to think or check facts. All they are going to hear is a bunch of spoiled people in a highly paid field whining that they couldn't pass a test.

If you are going to write letters then focus your efforts on the ABR, Wallner, etc.

These are very good points. The New York Times has a history of publishing anti-physician articles and in particular seems to have an obsession with claiming that doctors are overpaid. I do not think they or a similar outlet would be sympathetic unless there was actual evidence of the ABR (an email perhaps) deliberately making these changes to try and harm the reputation of small/community programs. There would have to be a big guy vs. little guy story and an angle to the public that they are trying to create a system where only wealthy big city Americans are getting quality cancer care due to the ABR creating a perception that the only way to be a competent clinician is to train in a large academic center with heavy translational research output. And tie that somehow to driving up the cost of health care by funneling all cancer care to expensive large academic centers. This is a stretch to say the least. Realistically, the only issue the NYT would want to investigate would be recalls/cheating, and they would jump right to the cost of grandma's radiation treatment being due to cheating doctors trying to get rich.

I'd much rather see a quality well-written editorial laying out the problems with the bio and physics exam in a major academic journal. I'm hopeful a leader in our field will be willing to stand up for us and stick his/her neck out.
 
It is ridiculous. They made a ridiculous exam, failed over a third of examinees, and then told us it was our fault for not being smart enough.

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Who here knows the actual pass/fail rates?
Oh right, No-one...
Lots of conjecture, and no actual numbers. The plural of anecdote is not "data"
 
That is not true. People that failed can still practice, albeit for less salary. All this does is it allows big corporations like 21st century to pay them less to babysit machines.

As Ramses was saying, the readers of the NY Times are not going to care that a test for licensing doctors was hard. If anything, they'd prefer it be. They might be upset to find out that somebody who failed it can still practice, so be careful what you wish for.
 
I would like to apologize to the residents that failed this year. You have to come to this forum to share a very personal matter with your colleagues only to be called whiners, conspiracy theorists, and being responsible for residency expansion. I have never followed a thread closely until now. I did not take the exam but I feel a sadness for you all because you are my colleagues. These are not just fellow physicians that are struggling, these are our fellow radiation oncologists. To those that think publicity will be bad in this matter, it could not be nearly as bad as the way these residents are treated in this thread by their colleagues. For that I am sorry.

I have little power but will do whatever I can to defend you. Although the pass rate is arbitrary I can vouch for the numbers being presented here. It is impossible for these scores to happen because of poor quality residents/teaching. Impossible. Period. For a field that loves the nuances of data how could this possibly be a reasonable explanation? To those that suggest an email to Dr. Wallner will suffice, I completely disagree. We have already sacrificed enough for medicine. Why do we continue to be okay with the encroachment of arbitrary exams on our time? My time is my most valuable resource. I will pay the ABR thousands of dollars. I'll pay them five times what they want. If they want money I will pay- no questions asked. But when you start taking my time then we will have a fight. I cannot understand the sentiment to stand down and take it. Stand up and defend your time.

The company culture slideshare deck from Netflix is inspiring for many reasons. They have achieved tremendous success in part because of their culture. Central to their culture is to always be questioning. Why do we have this exam? What value does it provide? What is the opportunity cost? Why do you not tell me what to study? What evidence do you have that resident quality is declining? Of course you will be called a millennial for asking questions to the grandfathers but so what. Uber questioned the taxi cab monopoly, airbnb questioned hotels. Always ask questions. The purpose of spreading this story is to hold the ABR accountable. There is no thought by anyone that they general public cares. We should care. We are radiation oncologists and these are our colleagues.
 
Thank you again to everyone who has been emailing us at ARRO. We are continuing to work together and collect your emails and comments to make sure that ABR hears them. We apologize for not responding to all emails as we continue to work on this and hope that you continue to reach out to us through social media or email. Please know that each one of your emails is important to us and we are doing our diligence to make sure we properly represent you arro AT astro org
 
I But when you start taking my time then we will have a fight. I cannot understand the sentiment to stand down and take it. Stand up and defend your time.

exactly how I feel about this issue and so many things in medicine. How many more pointless arbitrary exams do we need? we have been doing nothing but this this entire time (Step 2 CK, CS, Step 3, now this crap). The whole thing is a complete scam. There are always voices telling people to put their head down and bend the knee, they have been around us ever since we were children. As an adult hearing these voices still as a grown person, I resent them. There are always so many people not willing to fight the good fight, it keeps the already sh*tty status quo in place. Tell me what exactly do you hope to gain from "respectfully" discussing something over email with someone who is clearly not going to do the right thing, or change their mind? its a futile thing. We need to be bold here!
 
The existential questioning of the value of board exams and certifications is not new, it is generations old. As noted AAPS consistently fights this. Go read their news letters about their other positions if you are so inclined.

They remain in place for a very obvious and practical region - if there is no certification or test of competence, then anyone can do whatever they want. To hear people opine about the value of evaluating some standard knowledge base or competency of physicians as having no function is simply appalling.

Of course the specialty societies make money off of it. Welcome to capitalism. But there is a very real function of having standards and evaluation of people who wish to call themselves a physician of specialty X. The opposite is anyone can open any program, graduate anyone they want, and who cares what they teach clinical or otherwise. Having board exams and maintenance of certification is not a scam without purpose, even if those exams are imperfect.

And when you start posting drivel about Wallner having an ulterior motive to fail everyone so he can hire you as cheaper linac baby sitters for the very not well running 21st century oncology, you brought the label of conspiracy theorist upon yourselves.
 
OK, I'm gonna go ahead and say that I disagree that we should be arguing to do away with board certifications. It is ultimately what protects us from being supplanted by PA's that can contour.

The majority of ppl who took the tests this year passed them. Keep that in mind while feeling entitled to a mulligan.
 
OK, I'm gonna go ahead and say that I disagree that we should be arguing to do away with board certifications. It is ultimately what protects us from being supplanted by PA's that can contour.

The majority of ppl who took the tests this year passed them. Keep that in mind while feeling entitled to a mulligan.

Don’t disagree with you. Do you mind sharing how you did on this year’s radbio exam? Study tips would be much appreciated! Thanks


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Very interesting to see the people taking the side of the ABR and status quo. Some people who have not even posted in 10 years are even coming out. i guess the ABR is sending out their sycophant army and trolls.
 
OK, I'm gonna go ahead and say that I disagree that we should be arguing to do away with board certifications. It is ultimately what protects us from being supplanted by PA's that can contour.

The majority of ppl who took the tests this year passed them. Keep that in mind while feeling entitled to a mulligan.

So, just to be clear, do you think the content on the rad bio exam this year was fair and a reasonable measure of minimum competence for a radiation oncologist? Did you find none of it surprising and felt your instructors prepared you adequately with existing texts and resources?

DebtRising, I'm struggling to keep up with your strawmen arguments. I am not saying that board certification is worthless and is a complete scam. The issue is not that we are whining about having to take an exam. The issue is that new standard that was suddenly set for bare minimum competence was ridiculous. Yes, I believe there was an ulterior motive, perhaps not to make an already wealthy man slightly wealthier by saving a few bucks with non-BC labor, but there was something more reasonable like a bias against less-research-focused community programs. The nonsensical publication prior to the exam earlier this year in reference to resident quality and publications about rad bio education emphasis support this. Pass rates <70% support this when historical averages are 92% with < 4% standard deviation (where are they, ABR? It's not a secret anymore and shame on you for thinking you could keep them a secret). You are free to disagree. But stop trying to bully us and shame us into submission.

I find myself over and over questioning myself, trying to be reasonable. Asking myself, was this really in actuality all my fault that I failed the rad bio exam (a minimal competency exam). And I'm thinking for a minute. Well maybe if I had done every single rad bio practice question in existence, took 25 Rabex exams, audited some graduate level cancer biology courses. And then I stop and think, no. Just no. This wasn't right. We are so accustomed to just sitting back and taking it and blaming ourselves for everything in medical training. For being too weak, feeling ashamed for being tired after 80 hour weeks as interns. I'm having this internal debate daily.
 
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