Rad onc rankings

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Everyone has their own rankings but this is what I would generally say:

Big 3: HROP, MDACC, MSK

A Tier: Penn, Stanford, UCSF
Mayo, Hopkins, WashU, Michigan

Regionally Strong:
East Coast: Yale, Sinai, NYU
Midwest: UChicago, Cleveland Clinic, Wisconsin
West Coast: UCLA, UCSD
South: Duke, UTSW, UF

But there are still other programs not mentioned here that are still good programs.
Where does Vanderbilt stand among these? Does it make regionally Strong or nah?
 
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Where does Vanderbilt stand among these? Does it make regionally Strong or nah?
I'm not really sure I see much difference reputationally after the big 3 and before the true bottom. Vandy is fine as its a big well known academic center. Depends on what you're going for. Vandy's name is well-regarded throughout south and probably midwest, and not chopped liver elsewhere,
 
I referred several patients to a surgical subspecialist from a so-called elite institution (big 3). Former faculty and new to private practice. Unfortunately, their academic pedigree hasn't translated to good surgical outcomes or 3 A's.

Obsess if you want about rankings but it's a wash in the end.
 
I referred several patients to a surgical subspecialist from a so-called elite institution (big 3). Former faculty and new to private practice. Unfortunately, their academic pedigree hasn't translated to good surgical outcomes or 3 A's.

Obsess if you want about rankings but it's a wash in the end.
Mostly I mean perception-wise, and to a degree that's what counts. From a patient POV in the South at least, it feels like order of prestige is MDACC, Harvard=Duke, Emory=Vanderbilt, then probably Stanford or something. It mostly has to do with name recognition when you walk into a room in a given geography, and I don't think Penn means a ton in smaller towns.
 
Mostly I mean perception-wise, and to a degree that's what counts. From a patient POV in the South at least, it feels like order of prestige is MDACC, Harvard=Duke, Emory=Vanderbilt, then probably Stanford or something. It mostly has to do with name recognition when you walk into a room in a given geography, and I don't think Penn means a ton in smaller towns.
Do patients even know what MD Anderson is? I first even heard of that name 6 months ago.
 
MDACC's marketing budget is enormous, meaning 9 figures. Patients certainly know what it is.
 
MDACC's marketing budget is enormous, meaning 9 figures. Patients certainly know what it is.
In my experience, a decent number of people have no idea who the big names are. When I was in the Midwest, everyone knew about Mayo Clinic. I’m in the NE now and a surprising number of people here have never heard of MSKCC.

I see a couple buckets of people. There are absolutely some people who want “the best” and will pass 8 CCCs on their way to MDACC for stage 1 breast cancer. There are people who do no research and go to the place closest to their house. My favorite are the savvy ones in the middle who ask about going to the big boys and on their own go, “wait, they have the same machines you do, follow the same guidelines, and participate in many of the same trials?” Don’t get me wrong, I’ll tell the zebras to go for second opinions or very good trials I don’t have open. But mad respect to the lay folk with bread and butter cancers who see the marketing for what it is.