Please do not shame students who match at terrible programs

[speakeroftruth]

This is going to be controversial - perhaps one way to encourage programs to close (because we all know programs are not voluntarily going to give up cheap labor) is to shame students who match at the worst of the worst programs (Kansas, North Shore/LIJ, MUSC, Allegheny, Arkansas, Columbia, Oklahoma, West Virginia, + others I'm missing). Those grads will most likely be shunned anyways in 5 years when they go on the job market and likely have to be hired by their home institutions as we've all seen in recent years. But we could have a role in ensuring that students understand that they'll be ridiculed on social media (probably just SDN or anonymous Twitters) if you rank and match at the worst programs in the country. Having talked to students at a couple of intuitions, I know most students at least lurk on SDN. In that same vein, we have SOAP data by years and could shame those students as well.

The idea would be that over a short time hopefully, students will feel pressure not to rank or SOAP into certain programs and thereby leading to those programs contracting or closing. I understand this is probably having too high of a hope but we all need to do something to cut residency spots and stop the crazy amount of SOAPing.

I truly hate the idea of shaming students. I have seen some of the applications over the last few years and my goodness, there are increasingly terrible applicants and this year has probably at least 25% of whom would be lucky to SOAP into the least competitive specialties. Our field is dying and increasingly attracting some of the worst, non-competitive applicants who are going to take horrible job offers (low pay with high RVU requirements) because they will have no other options and this will only hurt the rest of us all in the long run.

Is this being unreasonable?

Edit: Had to add Oklahoma.
Edit 2: How could I forget West Virginia


Moderator (Neuronix) edit: I almost never do this, but the original title of this thread was getting too much negative publicity both on and off SDN, and so I changed it. SDN's mission is to help students. Every poster in this thread after the original post was against the idea of shaming students who matched at low-tier programs. SDN is a forum for open communication and ideas are welcome. Still, I felt it necessary to intervene in this particular case because the thread title was too opposed to SDN's mission of helping students become doctors.

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[OTN]

I don't want to shame students. I want to shame the faculty and residents who continue to lie to them about the state of our field.

 

[seper]

Well, some of the people applying RadOnc this year are not clueless students, but folks affected by massive life problems. Think of someone with a chronically sick child, lack of US visa, etc. They cannot get another job so shaming is cruel.

 

[communitydoc13]

Don't do it. Classic victim shaming. Aggressive and public criticism of those in power is always appropriate. Probably shouldn't even shame your peers.

 

[RickyScott]

This is going to be controversial - perhaps one way to encourage programs to close (because we all know programs are not voluntarily going to give up cheap labor) is to shame students who match at the worst of the worst programs (Kansas, North Shore/LIJ, MUSC, Allegheny, Arkansas, Columbia, + others I'm missing). Those grads will most likely be shunned anyways in 5 years when they go on the job market and likely have to be hired by their home institutions as we've all seen in recent years. But we could have a role in ensuring that students understand that they'll be ridiculed on social media (probably just SDN or anonymous Twitters) if you rank and match at the worst programs in the country. Having talked to students at a couple of intuitions, I know most students at least lurk on SDN. In that same vein, we have SOAP data by years and could shame those students as well.

The idea would be that over a short time hopefully, students will feel pressure not to rank or SOAP into certain programs and thereby leading to those programs contracting or closing. I understand this is probably having too high of a hope but we all need to do something to cut residency spots and spot the crazy amount of SOAPing.

I truly hate the idea of shaming students. I have seen some of the applications over the last few years and my goodness, there are increasingly terrible applicants and this year has probably at least 25% of whom would be lucky to SOAP into the least competitive specialties. Our field is dying and increasingly attracting some of the worst, non-competitive applicants who are going to take horrible job offers (low pay with high RVU requirements) because they will have no other options and this will only hurt the rest of us all in the long run.

Is this being unreasonable?

While naming specific residents will hurt your cause, It is certainly reasonable to commit to not hiring from some programs. Enough spots at decent places for all US MDs! There is simply no good reason to attend LIJ or Arkansas. These places almost certainly dont care about residents or they wouldnt exist to begin with. If a resident absolutely had to be in certain geography, radiation is a really really poor decision! If a job opened up in my facility, I just cant think of a circumstance in which I would ever hire from a West Virginia/LIJ/Arkansas (unless I was trying to go with someone who wouldnt threaten my ego.) Frankly, in a few years, there will be tons of AOA types with several years of experience looking to get out of exploitative practices in dumpy locations, that employers can pick from.

 

[speakeroftruth]

Thanks all for the replies. It is just frustrating, I feel like I should/could be doing more. I have actively and successfully discouraged students at my own institution from applying into rad onc. It feels like too little, too late.

 

[evilbooyaa]

I am against this and will be deleting/warning posts who do this on SDN as this leaves a foul taste in my mouth and would fall into general 'unprofessional content'. I cannot police Reddit/Twitter.

Programs are fair game for criticism, but I do not think this (shaming students/residents simply for where they are doing residency) is an acceptable manner of fighting against the glut of residency positions.

I am happy to allow this thread to remain open for further discussion of this topic, but if any actual shaming is done ITT I will be deleting posts and locking.

 

[RadRadRad]

Maybe I’m old and from a different era but public shaming/mob rule seems like an increasing trend nationwide. It’s all good until the mob comes after you

would be much more in favor of objective criticisms or changes to reduce residency spots
-lack of faculty to team radbio/physics
-lack of breadth of faculty to teach all disciplines of clinical radonc
-poor performance of residents on board
Etc
....

 

[radonc17]

Agreed with all of the above. Students applying are likely some combination of dedicated, ambitious, optimistic, and/or naiive. Shouldn't be shamed.

It is the fault of programs taking advantage of the situation IMO

 

[RadOncMegatron]

I agree, shaming students and residents is not good. We are not sure of what "rah rah #radoncrocks" they are hearing. They will feel the pain after they graduate soon enough. The programs should be open to criticism.

Bigger message is that it has come to this....

 

[medgator]

Plenty of exploitative and shameless faculty to call out. No need for this.

Name and shame.

Think: L Potters, Michael steinberg, Marcus Randall, Dennis hallahan etc

 

[StIGMA]

I reported this thread to be deleted. This is a horrible idea and shouldn't be kept open on this forum to even implicitly encourage the idea.

Agree with others re: shaming the leadership of the programs.

 

[Mandelin Rain]

"Shaming students who match at terrible programs"

 

[seper]

Agreed with all of the above. Students applying are likely a combination of dedicated, ambitious, optimistic, and naiive. Shouldn't be shamed.

It is the fault of programs taking advantage of the situation IMO

I interviewed 18 this season and only 2 or 3 were dedicated, ambitious, optimistic, or naiive. The rest were making a calculated choice

 

[IRattending2021]

I interviewed 18 this season and only 2 or 3 were dedicated, ambitious, optimistic, or naiive. The rest were making a calculated choice

why would they make such a choice? What type of choice are they making?

 

[scarbrtj]

"Shaming students who match at terrible programs"

I find ways to work this into a convo at least once a day. May God have mercy on your soul.

 

[Mandelin Rain]

I interviewed 18 this season and only 2 or 3 were dedicated, ambitious, optimistic, or naiive. The rest were making a calculated choice

 

[drewdog1973]

This is the most horrible idea I've heard in a long time. And, I am in radiation oncology which is the Licensed Home Of Terrible Ideas.

 

[RickyScott]

The calculated choice is that if they make it to Harvard or MSKCC, our field is so enamored with program name that they will have a big advantage in the job search. We will somehow ignore AOA types who matched in pior absurdly competitive years into low/mid range residencies, many of whom will also be looking to change jobs in the future.

 

[OTN]

The calculated choice is that if they make it to Harvard or MSKCC, our field is so enamored with program name that they will have a big advantage in the job search. We will somehow ignore AOA types who matched in pior absurdly competitive years into low/mid range residencies, many of whom will also be looking to change jobs in the future.

What current medical students need to understand is that those of us in hiring positions down the line a few years from now when they're graduating likely will be preferentially looking to those physicians who matriculated into radonc residencies during the golden years. Not only are they excellent "AOA types," but I have no reason to question their decision-making ability, information-gathering ability, and judgement when it comes to serious, long-term career decisions.

 

[RickyScott]

What current medical students need to understand is that those of us in hiring positions down the line a few years from now when they're graduating likely will be preferentially looking to those physicians who matriculated into radonc residencies during the golden years. Not only are they excellent "AOA types," but I have no reason to question their decision-making ability, information-gathering ability, and judgement when it comes to serious, long-term career decisions.

Yip, we will be so blown away by the name that we will completely forget that the specialty had "golden" years. Academia feeds into this garbage with an unhealthy emphasis on prestige, that it will somehow paper over everything including lack of jobs.

 

[seper]

What current medical students need to understand is that those of us in hiring positions down the line a few years from now when they're graduating likely will be preferentially looking to those physicians who matriculated into radonc residencies during the golden years. Not only are they excellent "AOA types," but I have no reason to question their decision-making ability, information-gathering ability, and judgement when it comes to serious, long-term career decisions.

I'd have to disagree here... As you know what truly matters day-to-day, is the ability for an attending 1) to go along with clinical consensus and 2) to prescribe the maximally reimbursable regimen to make sure RadOnc Dept get it's "fair share of the case". Dinosaurs who matched in 80's do it equally well as us, the golden era prodigy

 

[medgator]

I'd have to disagree here... As you know what truly matters day-to-day, is the ability for an attending 1) to go along with clinical consensus and 2) to prescribe the maximally reimbursable regimen to make sure RadOnc Dept get it's "fair share of the case". Dinosaurs who matched in 80's do it equally well as us, the golden era prodigy

You trust Dinosaurs from the 80s to do SBRT and pelvic/h&n IMRT competently?

 

[FrostyHammer]

Agree with everyone else that they shouldn't be shamed for matching at the piss-poor programs you mentioned above (Kansas, North Shore/LIJ, MUSC, Allegheny, Arkansas, Columbia plus many more)........but at the same time internally, we should really be wondering what the sanity is of those med students who consciously make the decision to APPLY to these train-wreck programs in the first place. Pardon my language but I would rather drink piss than apply to any of those programs.

 

[speakeroftruth]

I deserve to be blasted. It was more of a passing thought that I should have thought twice about before posting. Apologies if I offended anyone.

Not to cast the blame aside from myself but the state of rad onc is truly horrendous if people like me are posting crazy stuff like this as potential solutions for residency overexpansion and the terrible job market.

 

[ramsesthenice]

Agree with everyone else that they shouldn't be shamed for matching at the piss-poor programs you mentioned above (Kansas, North Shore/LIJ, MUSC, Allegheny, Arkansas, Columbia plus many more)........but at the same time internally, we should really be wondering what the sanity is of those med students who consciously make the decision to APPLY to these train-wreck programs in the first place. Pardon my language but I would rather drink piss than apply to any of those programs.

Your appreciation for human cognitive abilities seems to have gotten too high. Go spend an hour or so at Walmart, preferably on a weekend. Med students are cut from the same fabric, they are just better test takers. It will suddenly all make sense again, I promise.

 

[IRattending2021]

Here’s the other thing. Is it immediately obvious to med student that those are poor programs? Places like Columbia are top notch in almost everything else.

 

[drewdog1973]

Agree with everyone else that they shouldn't be shamed for matching at the piss-poor programs you mentioned above (Kansas, North Shore/LIJ, MUSC, Allegheny, Arkansas, Columbia plus many more)........but at the same time internally, we should really be wondering what the sanity is of those med students who consciously make the decision to APPLY to these train-wreck programs in the first place. Pardon my language but I would rather drink piss than apply to any of those programs.

Appreciate you spelling Allegheny correctly. Was thinking all of SDN was trying to punk me with EVERY SINGLE PERSON spelling it wrong.

 

[Grubbe-a-dub-dub]

You can't fault medical students for applying to rad onc. I am a vastly different person now than who I was as beady-eyed MS4 applying for residency. I remember how ignorant and naive I was and how little I really knew about the dynamics at play in the medical field as a whole.

The only thing we can do is to continue to honestly tell them about the current state of the field. Essentially, stay as far away from it as you can. Most of the clowns on Twitter and at these ivory tower institutions like MDACC and MKSCC are straight-up lying to you.

This is not just 1 or 2 disgruntled people, this is an entire generation of trainees who are quite unhappy with their jobs or prospects for a job.

 

[FrostyHammer]

Appreciate you spelling Allegheny correctly. Was thinking all of SDN was trying to punk me with EVERY SINGLE PERSON spelling it wrong.

Actually lol I copied and pasted that whole thing from the OP - that program and all others on that list are not even worth spelling correctly

 

[medgator]

You can't fault medical students for applying to rad onc. I am a vastly different person now than who I was as beady-eyed MS4 applying for residency. I remember how ignorant and naive I was and how little I really knew about the dynamics at play in the medical field as a whole.

The only thing we can do is to continue to honestly tell them about the current state of the field. Essentially, stay as far away from it as you can. Most of the clowns on Twitter and at these ivory tower institutions like MDACC and MKSCC are straight-up lying to you.

This is not just 1 or 2 disgruntled people, this is an entire generation of trainees who are quite unhappy with their jobs or prospects for a job.

Remember it was 2/3 at best when times were good.... Not a far drop to 1-0/3.

 

[seper]

You trust Dinosaurs from the 80s to do SBRT and pelvic/h&n IMRT competently?

Yes where I work Physics fixes most errors

 

[seper]

why would they make such a choice? What type of choice are they making?

Some could not match into other speciality (rads, IM) and are re-applying this year. Some are older, have serious family problems and want a specific region. A few wanted to be competetive in choosing a job but have poor credentials.

 

[GreySwan]

This is going to be controversial - perhaps one way to encourage programs to close (because we all know programs are not voluntarily going to give up cheap labor) is to shame students who match at the worst of the worst programs (Kansas, North Shore/LIJ, MUSC, Allegheny, Arkansas, Columbia, Oklahoma, West Virginia, + others I'm missing). Those grads will most likely be shunned anyways in 5 years when they go on the job market and likely have to be hired by their home institutions as we've all seen in recent years. But we could have a role in ensuring that students understand that they'll be ridiculed on social media (probably just SDN or anonymous Twitters) if you rank and match at the worst programs in the country. Having talked to students at a couple of intuitions, I know most students at least lurk on SDN. In that same vein, we have SOAP data by years and could shame those students as well.

The idea would be that over a short time hopefully, students will feel pressure not to rank or SOAP into certain programs and thereby leading to those programs contracting or closing. I understand this is probably having too high of a hope but we all need to do something to cut residency spots and stop the crazy amount of SOAPing.

I truly hate the idea of shaming students. I have seen some of the applications over the last few years and my goodness, there are increasingly terrible applicants and this year has probably at least 25% of whom would be lucky to SOAP into the least competitive specialties. Our field is dying and increasingly attracting some of the worst, non-competitive applicants who are going to take horrible job offers (low pay with high RVU requirements) because they will have no other options and this will only hurt the rest of us all in the long run.

Is this being unreasonable?

Edit: Had to add Oklahoma.
Edit 2: How could I forget West Virginia

Yet someone did exactly that on the google sheet 30 minutes prior to the post here, and the sheet suddenly turned into a forum to spew hatred towards DOs, the field, and the job market.

 

[salubalu]

it’s funny how such an idea to shame residents who go to certain programs is even entertained...yet it’s also leadership from “prestigious” programs who many on this forum blame for the current position of our field...there are other things than where you graduated from that can make you a successful bright Hard working physician

 

[thecarbonionangle]

Thanks all for the replies. It is just frustrating, I feel like I should/could be doing more. I have actively and successfully discouraged students at my own institution from applying into rad onc. It feels like too little, too late.

I understand your frustration. I think it just reflects the sickening feeling of doom we all feel about the field. Applications are increasingly reflecting truly low quality applicants, some with criminal records, failure of steps, etc etc. i had a hard time understanding some of them and I worry about their ability to communicate. My chairman said to me multiple times that “we just have to match”.

Refer to my hellpit list i posted in the terrible no good program thread. These are terrible places to train. A few years ago even these places were getting excellent students and able to put out good rad oncs because people taught themselves. Now imagine these hellpit places training people in current warm body state of field. My anger is with these places, the “leadership” and the residents who straight up lie to people in these places (have seen it on social media). There are residents facilitating this. Of course, plenty of gaslighting faculty as well. Definitely a special place in hell for this crew.

The question is how to turn this anger and frustration into something productive. Yelling at Lisa Kachnic or Paul Wallner at ASTRO, or hurting a resident will not get us anything. Light, transparency and truth is the most important thing to root out these hellpit vermin places. We must continue to expose them.

 

[IRattending2021]

Yet someone did exactly that on the google sheet 30 minutes prior to the post here, and the sheet suddenly turned into a forum to spew hatred towards DOs, the field, and the job market.

can someone pm me the link to that sheet? I cannot find it by googling. Curious to see what the students have to say.

 

[thecarbonionangle]

can someone pm me the link to that sheet? I cannot find it by googling. Curious to see what the students have to say.

Google “reddit specialty spreadsheet”. It has one for most specialties

 

[fiji128]

Not sure why people refer to this as "the google spreadsheet" or "sdn spreadsheet" or whatever. It is a open editable spreadsheet for each medical specialty that is hosted on Reddit. Easy to find via the Google search engine.

 

[elementaryschooleconomics]

Not sure why people refer to this as "the google spreadsheet" or "sdn spreadsheet" or whatever. It is a open editable spreadsheet for each medical specialty that is hosted on Reddit. Easy to find via the Google search engine.

I refer to it as such because it's hosted by Google Docs (but linked through Reddit, yes)

 

[ramsesthenice]

We must continue to expose them.

I would argue that there is a small but very important tweak that needs to be made with this statement. What we need to do is encourage people with first hand knowledge and experience of these places to speak up and share. When one person rips off a list of 20 places to avoid for general(ish) reasons, it is way to easy to discredit. Someone saying I would not recommend X place because of A, B, C...that carries a lot more weight.

 

[thecarbonionangle]

I would argue that there is a small but very important tweak that needs to be made with this statement. What we need to do is encourage people with first hand knowledge and experience of these places to speak up and share. When one person rips off a list of 20 places to avoid for general(ish) reasons, it is way to easy to discredit. Someone saying I would not recommend X place because of A, B, C...that carries a lot more weight.

Someone doesn’t necessarily have to be a resident somewhere to know about it. It is a small field and your friends tell you things about their programs in privacy. Should they be doxed so this has “legitimacy” in the eyes of some? So say i know for a fact that multiple programs have had multiple board failures over past 5-10years, some with multiple even 2-3 yrs ago or even last year in their sorry excuse for “educational” program, should i just cover this up? Say i know a place has horrible job placement and has put out unemployed, underemployed locums and people have limited help getting jobs, should it be withheld because one did not personally go there for residency?

I’d encourage you to post what you know to be true. I know you know.

 

[Ray D. Ayshun]

I don't think shaming anyone specifically is worthwhile. We should all be ashamed, and based on the discussion on the spreadsheet, I can't say any of these applicants has stood out as not being an asshat, so it's hard to feel pity. It's in my rearview, but the concentration of weirdos at academic centers is only gonna increase, which is good for my bottom line. Does the nurse doing check-in have to inform the patient the doctor seeing them is a convicted sex offender?

 

[RickyScott]

I don't think shaming anyone specifically is worthwhile. We should all be ashamed, and based on the discussion on the spreadsheet, I can't say any of these applicants has stood out as not being an asshat, so it's hard to feel pity. It's in my rearview, but the concentration of weirdos at academic centers is only gonna increase, which is good for my bottom line. Does the nurse doing check-in have to inform the patient the doctor seeing them is a convicted sex offender?

As a patient, I would rather be under the care of a Sex offender who was being given a second chance than a doc who was incompetent/*****/couldn’t match into anything else.

 

[radonc2028]

I lurk on SDN often but I had to make an account to reply to this. Why would you shame people you don't know? You don't actually know why they chose that program. This is punishing an entirely wrong group of people. What they ARE genuinely interested in radiation oncology despite the doomsday, and it so happens that the program is near their family? Their partner has a job there? They are couples matching and their partner likes that institutions program?

Also, I don't understand why people are so hell bent on program name. It's possible to get into good programs for the wrong reason (like your sibling went there). The entire interview process is s a ****show anyway and mediocre to flat out terrible candidates can get accepted into excellent programs for a reason unrelated to actual ability. Or perhaps these people are good at benchwork but suck at doctoring and actually knowing how to practice medicine. The MD PhD guy with the best research funding in my residency did not know how to contour, was often unsure on how to treat people, hated being in clinic; he didn't even realize the right and left switches when you go feet first into the CT. [I'm not bashing MD PhD, I'm just pointing out that mediocrity can lurk in superior clothing]. I know graduates from someone's list of 'best programs' who are incompetent at clinical work. They don't know how to prescribe pain medication. They can't get notes done on time. They have failed same boards more than once. Their clinical plan are very closely followed by someone more competent. With your philosophy, you can end up hiring that incompetent idiot over someone who genuinely loves rad onc but needed to be NYC because they were couples matching and the partner was going into a competitive field (or just loved a Columbia program) or their dying mom lives in Kansas.

This is an awful solution. Shame the bad programs all you want but it's wrong to abuse vulnerable residents of which you know nothing. It actually is possible to graduate from a bad program and still be an excellent doctor because you know how to ask the right questions and do self-teaching; while a lazy person coming out of an excellent program is still lazy.

A bigger concern I have is the toxic practices out there. We should start a list of toxic practices. We're going to be playing musical chairs for many years, we may as well know which chairs are worth the move. These practices don't deserve hundreds of people applying to their crappy jobs or at least the person who takes the job should know to rent, not buy until it has been several years and they actually are happy to stay.

 

[IRattending2021]

I lurk on SDN often but I had to make an account to reply to this. Why would you shame people you don't know? You don't actually know why they chose that program. This is punishing an entirely wrong group of people. What they ARE genuinely interested in radiation oncology despite the doomsday, and it so happens that the program is near their family? Their partner has a job there? They are couples matching and their partner likes that institutions program?

Also, I don't understand why people are so hell bent on program name. It's possible to get into good programs for the wrong reason (like your sibling went there). The entire interview process is s a ****show anyway and mediocre to flat out terrible candidates can get accepted into excellent programs for a reason unrelated to actual ability. Or perhaps these people are good at benchwork but suck at doctoring and actually knowing how to practice medicine. The MD PhD guy with the best research funding in my residency did not know how to contour, was often unsure on how to treat people, hated being in clinic; he didn't even realize the right and left switches when you go feet first into the CT. [I'm not bashing MD PhD, I'm just pointing out that mediocrity can lurk in superior clothing]. I know graduates from someone's list of 'best programs' who are incompetent at clinical work. They don't know how to prescribe pain medication. They can't get notes done on time. They have failed same boards more than once. Their clinical plan are very closely followed by someone more competent. With your philosophy, you can end up hiring that incompetent idiot over someone who genuinely loves rad onc but needed to be NYC because they were couples matching and the partner was going into a competitive field (or just loved a Columbia program) or their dying mom lives in Kansas.

This is an awful solution. Shame the bad programs all you want but it's wrong to abuse vulnerable residents of which you know nothing. It actually is possible to graduate from a bad program and still be an excellent doctor because you know how to ask the right questions and do self-teaching; while a lazy person coming out of an excellent program is still lazy.

A bigger concern I have is the toxic practices out there. We should start a list of toxic practices. We're going to be playing musical chairs for many years, we may as well know which chairs are worth the move. These practices don't deserve hundreds of people applying to their crappy jobs or at least the person who takes the job should know to rent, not buy until it has been several years and they actually are happy to stay.

so what are some of the hallmarks of a crappy radonc job?

 

[medgator]

so what are some of the hallmarks of a crappy radonc job?

Heres a start... Any job that keeps getting posted every few years as they churn through new grads and never make them partner

Job in Irvine?

I am looking into rad onc jobs in Irvine due to family reasons. There's no Irvine job postings on ASTRO website. Are there malignant employers in Irvine one should avoid? Searching through old messages on this forum, someone mentioned KSK? Thank you

forums.studentdoctor.net

 

[RickyScott]

I lurk on SDN often but I had to make an account to reply to this. Why would you shame people you don't know? You don't actually know why they chose that program. This is punishing an entirely wrong group of people. What they ARE genuinely interested in radiation oncology despite the doomsday, and it so happens that the program is near their family? Their partner has a job there? They are couples matching and their partner likes that institutions program?

Also, I don't understand why people are so hell bent on program name. It's possible to get into good programs for the wrong reason (like your sibling went there). The entire interview process is s a ****show anyway and mediocre to flat out terrible candidates can get accepted into excellent programs for a reason unrelated to actual ability. Or perhaps these people are good at benchwork but suck at doctoring and actually knowing how to practice medicine. The MD PhD guy with the best research funding in my residency did not know how to contour, was often unsure on how to treat people, hated being in clinic; he didn't even realize the right and left switches when you go feet first into the CT. [I'm not bashing MD PhD, I'm just pointing out that mediocrity can lurk in superior clothing]. I know graduates from someone's list of 'best programs' who are incompetent at clinical work. They don't know how to prescribe pain medication. They can't get notes done on time. They have failed same boards more than once. Their clinical plan are very closely followed by someone more competent. With your philosophy, you can end up hiring that incompetent idiot over someone who genuinely loves rad onc but needed to be NYC because they were couples matching and the partner was going into a competitive field (or just loved a Columbia program) or their dying mom lives in Kansas.

This is an awful solution. Shame the bad programs all you want but it's wrong to abuse vulnerable residents of which you know nothing. It actually is possible to graduate from a bad program and still be an excellent doctor because you know how to ask the right questions and do self-teaching; while a lazy person coming out of an excellent program is still lazy.

A bigger concern I have is the toxic practices out there. We should start a list of toxic practices. We're going to be playing musical chairs for many years, we may as well know which chairs are worth the move. These practices don't deserve hundreds of people applying to their crappy jobs or at least the person who takes the job should know to rent, not buy until it has been several years and they actually are happy to stay.

I agree with you about not shaming individual residents, but if someone absolutely needs to be in a specific location, they have made a horrible decision going for radonc. There certainly are some programs like Arkansas or West Virginia where there are zero legitimate reasons to attend.
for a resident who decides on Columbia- I get that not everyone can match at mskcc, but at least a 2nd tier program like NYU where you just have to be a us grad who passed boards on 1st try.

 

[medgator]

I agree with you about not shaming individual residents, but if someone absolutely needs to be in a specific location, they have made a horrible decision going for radonc. There certainly are some programs like Arkansas or West Virginia where there are zero legitimate reasons to attend.
for a resident who decides on Columbia- I get that not everyone can match at mskcc, but at least a 2nd tier program like NYU where you just have to be a us grad who passed boards on 1st try.

In this day and age, any halfway decent US/AMG can match into a top third/half program easily. If they can't, best to look elsewhere

 

[RickyScott]

In this day and age, any halfway decent US/AMG can match into a top third/half program easily. If they can't, best to look elsewhere

Agreed. If someone absolutely had to be in West Virginia, why wouldn’t you just train in Pitt (an hour away and program that also fills in soap). I think there is something to be said about questioning a residents judgement when it comes to one of the biggest decisions of their life- kind of a 🚩 if they can’t get that right.Nobody was born to be a radonc, and if you have very limited geographic requirements (ie absolutely have to be in arkansas), more likely than not you have very bad judgment pursuing this specialty.

disclaimer: when I went into the field, geography was by far and away my biggest priority, but that was before residency expansion ruined everything. While I love radonc, no way I would have gone in to this specialty today.