Rad Onc Twitter

[ROforbetterorworse]

Ummmm ASTRO can you take some lessons.....

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[ROforbetterorworse]

I've got to be honest, I've re-read this EM Tweet (and several others) and...I'm just so disappointed in us.

"Heartbroken" is probably overly dramatic, but with all the hand-wringing denialism of our "leaders" for YEARS, to watch another specialty just jump up and pay attention to similar issues...wow.

In Ed Halperin's piece about why there aren't more RadOnc Deans/Presidents, the criticisms he faced from other specialties as he interviewed for various jobs just ring true. There are some up-and-coming folks in the field that I'm somewhat optimistic about, but until the crew that has driven us into the ground are retired and silent...it's going to get worse, before it gets better.

@elementaryschooleconomics - Very accurate capture of how many of us feel

Better than I could have put into words. Thank you for this

 

[RickyScott]

@elementaryschooleconomics - Very accurate capture of how many of us feel

Better than I could have put into words. Thank you for this

In their defense, a lot of them are not very bright.

 

[CurbYourExpectations]

Pretty crazy to see how fast EM leaders reacted in comparison. How can we actively work towards getting people who care more about the future of the young RadOncs into leadership positions?

 

[StIGMA]

SDN on overtraining residents:

 

[medgator]

Spratt 💕💕 fest on Twitter today

 

[GI_RadOnc]

Spratt 💕💕 fest on Twitter today

I'm so rooting for this! Just walked the campus of Case & University Hospital a few weeks ago; very nice integrated feel; and you can walk to Cleveland Clinic from UH in 15-20 minutes as well. Lots of potential for clinical/academic growth. The city has had some faster growth and change ahead of it's 'industrial north' partners; cost of living is low. Three sport town... and the Browns didn't look too bad for once

And, if you're part of this vanguard group supported by someone who is both academically/social media/SDN savvy; not a bad place to position yourself...

I told Dan if I wasn't already settled in with family; and that they didn't already have someone far better than me in GI already; I would be knocking on the door!

 

[ROforbetterorworse]

I'm so rooting for this! Just walked the campus of Case & University Hospital a few weeks ago; very nice integrated feel; and you can walk to Cleveland Clinic from UH in 15-20 minutes as well. Lots of potential for clinical/academic growth. The city has had some faster growth and change ahead of it's 'industrial north' partners; cost of living is low. Three sport town... and the Browns didn't look too bad for once

And, if you're part of this vanguard group supported by someone who is both academically/social media/SDN savvy; not a bad place to position yourself...

I told Dan if I wasn't already settled in with family; and that they didn't already have someone far better than me in GI already; I would be knocking on the door!

How is walking from your employer, Case, to your non-employer and direct competitor, Cleveland Clinic, a pro?

 

[OTN]

Spratt 💕💕 fest on Twitter today

"Academic health system uses predatory billing to increase market share at the expense of private practice" would be another way to describe it.

I like Dr. Daniel Pratt, but let's be real here: Can you imagine a private group hiring 7 radoncs all at once in the same city? Of course not. Why not? Why isn't this even remotely possible in the private world, but lauded and celebrated in the academic one?

 

[RickyScott]

"Academic health system uses predatory billing to increase market share at the expense of private practice" would be another way to describe it.

I like Dr. Daniel Pratt, but let's be real here: Can you imagine a private group hiring 7 radoncs all at once in the same city? Of course not. Why not? Why isn't this even remotely possible in the private world, but lauded and celebrated in the academic one?

Very much doubt population in Cleveland is increasing much (if at all- probably declining). So where is this growth coming from (satellite buyouts/ force outs) and will they sustain these positions for greater than 5 years? Or maybe, they can just hire extra docs because they are billing such high prices which allows them to treat 120 pts per year?

 

[ROforbetterorworse]

"Academic health system uses predatory billing to increase market share at the expense of private practice" would be another way to describe it.

I like Dr. Daniel Pratt, but let's be real here: Can you imagine a private group hiring 7 radoncs all at once in the same city? Of course not. Why not? Why isn't this even remotely possible in the private world, but lauded and celebrated in the academic one?

His subsequent posts said he is not hiring all at once

Funny enough, I'm reminded of a time when prominent Houstonians gaslit and said no problems b/c they are hiring 10 ppl in 1 yr....

 

[GI_RadOnc]

Sorry; @ROforbetterorworse I'm a total Cleveland fan; did undergraduate there. Campus was just in far better shape than the 90s; where before the Clinic and UH were separated by some not-so-safe areas. If you were starting an academic career, it could be a good thing to have easily accessible collaborators.

I think the private groups had been pushed out / bought out between the Clinic and UH some years ago; to @OTN's point. I think @RickyScott they had a bunch of people leave to go to Penn State; and it's an aging population that is flat. At least it's seven more job opportunities than there were before (yes employed, yes academic, but what're you going to do?).

And I'm going to tell the young'uns on this board that working with a chair with a forward look is going to be important if you want a longer term career.. so if someone got a dean to pony up that many recruitment packages; it's a good start.

I promise I'm not part of radoncrocks; just got a touch of nostalgia about Cleveland. Good biryani.

 

[ROforbetterorworse]

Sorry; @ROforbetterorworse I'm a total Cleveland fan; did undergraduate there. Campus was just in far better shape than the 90s; where before the Clinic and UH were separated by some not-so-safe areas. If you were starting an academic career, it could be a good thing to have easily accessible collaborators.

I think the private groups had been pushed out / bought out between the Clinic and UH some years ago; to @OTN's point. I think @RickyScott they had a bunch of people leave to go to Penn State; and it's an aging population that is flat. At least it's seven more job opportunities than there were before (yes employed, yes academic, but what're you going to do?).

And I'm going to tell the young'uns on this board that working with a chair with a forward look is going to be important if you want a longer term career.. so if someone got a dean to pony up that many recruitment packages; it's a good start.

I promise I'm not part of radoncrocks; just got a touch of nostalgia about Cleveland. Good biryani.

I agree with you that hiring someone is better than hiring no one, and that Spratt seems like a potential disruptor

Not sure how much of this is directly due to Spratt

They have been trying to hire since when I was looking for attending jobs, unsuccessfully, due to being a poorly run dept

They have filled some of those this year finally with bad market

 

[RickyScott]

Sorry; @ROforbetterorworse I'm a total Cleveland fan; did undergraduate there. Campus was just in far better shape than the 90s; where before the Clinic and UH were separated by some not-so-safe areas. If you were starting an academic career, it could be a good thing to have easily accessible collaborators.

I think the private groups had been pushed out / bought out between the Clinic and UH some years ago; to @OTN's point. I think @RickyScott they had a bunch of people leave to go to Penn State; and it's an aging population that is flat. At least it's seven more job opportunities than there were before (yes employed, yes academic, but what're you going to do?).

And I'm going to tell the young'uns on this board that working with a chair with a forward look is going to be important if you want a longer term career.. so if someone got a dean to pony up that many recruitment packages; it's a good start.

I promise I'm not part of radoncrocks; just got a touch of nostalgia about Cleveland. Good biryani.

I am not trying to diminish Cleveland, case or spratt- just trying to point out this is not likely to be growth in overall job market.

 

[seper]

We discussed this in the past. I'm friends with a few CC / Ohio docs... Most of these jobs will be a classic satellite gig much derided on this board. 5-10 patients under the beam and numbers very unstable due to ever-shifting competition. One advice I would give is not to rely on their individual bonus projections when trying to figure out future income. Another advice to expect a lot of traveling and cross-coverage on short notice.

 

[DebtRising]

We discussed this in the past. I'm friends with a few CC / Ohio docs... Most of these jobs will be a classic satellite gig much derided on this board. 5-10 patients under the beam and numbers very unstable due to ever-shifting competition. One advice I would give is not to rely on their individual bonus projections when trying to figure out future income. Another advice to expect a lot of traveling and cross-coverage on short notice.

And that is the current game. Until APM and short courses drives the fiscal reality of the geographic market share approach to an unsustainable level. 5-7 years is my guess.

 

[Radonc90]

I thought in 2002, Cleveland Clinic and Case Western got married (marriage made in Heaven)???

 

[ROforbetterorworse]

I thought in 2002, Cleveland Clinic and Case Western got married (marriage made in Heaven)???

They have shared teaching at medical schools, but still separate schools

The hospital systems are completely financially independent

 

[deleted573262]

They have shared teaching at medical schools, but still separate schools

The hospital systems are completely financially independent

They pay fewer faculty to teach and pocket the difference in tuition.

 

[TheWallnerus]

Another advice to expect a lot of traveling and cross-coverage on short notice.

Supervision is a bit of a zombie right now anyways. Waiting for some(entity) to shoot it in the brain and make this "supervision theater" die.

 

[ROforbetterorworse]

Academic radiation oncology at its finest

Becoming a trainee peer reviewer is a major accomplishment and destiny for superstardom!!!

 

[Grubbe-a-dub-dub]

Academic radiation oncology at its finest

Becoming a trainee peer reviewer is a major accomplishment and destiny for superstardom!!!

I applied to this program in residency and was flat out rejected. I guess I wasn't a superstar.

Sad thing was I was genuinely interested at the time, but now could careless about the Red Journal.

I'll go back to trying to be famous in our field through misguided Tweets...

 

[ROforbetterorworse]

I applied to this program in residency and was flat out rejected. I guess I wasn't a superstar.

Sad thing was I was genuinely interested at the time, but now could careless about the Red Journal.

I'll go back to trying to be famous in our field through misguided Tweets...

Welcome to mediocrity like the rest of us!

 

[metallica81788]

I'll go back to trying to be famous in our field through misguided Tweets...

Depending on which direction your Tweets go you could make more of a difference that way

 

[Ray D. Ayshun]

Batting 1.000 on sentences containing the word "super," which has sealed his fate with me.

 

[DoctwoB]

They pay fewer faculty to teach and pocket the difference in tuition.

Well the classroom part of medschool (and college for that matter) is a textbook example of inefficiency. Hundreds of schools giving the same lectures to mostly empty classrooms of varying quality. Everyone watches lectures virtually now anyways. You could easily make a medschool curriculum composed of excellent lecturers from across the country in a virtual format (with in person small group sessions with clinicians) for a third of the cost.

Of course schools have no incentive to do this, there are a lot of legacy costs to maintain (buildings, faculty, admin), and there is no shortage of applicants, and ultimately you are still paying for the name brand degree. What we really need is for some forward looking institution or group of institutions (say the UC or UT system) to do it.

 

[medgator]

 

[seper]

night shifts... bad setup for trying to keep family together
although, try to tell your spouse when you are graduating from UCSF RadOnc residency that the only interview you've got is one for assistant professor position in Louisville

 

[medgator]

night shifts... bad setup for trying to keep family together
although, try to tell your spouse when you are graduating from UCSF RadOnc residency that the only interview you've got is one for assistant professor position in Louisville

Probably better biryani in L'ville than Ponca City OK or Evansville IN

 

[RadsRocks!]

night shifts... bad setup for trying to keep family together
although, try to tell your spouse when you are graduating from UCSF RadOnc residency that the only interview you've got is one for assistant professor position in Louisville

My BF would leave me lol

 

[dieABRdie]

Um, what? Is this a troll account? Or am I actually seeing ASTRO publicly acknowledge they are putting up jobs for truck drivers due to job market concerns?

 

[tomballunger]

Um, what? Is this a troll account? Or am I actually seeing ASTRO publicly acknowledge they are putting up jobs for truck drivers due to job market concerns?

its a troll account. But the link is real

 

[elementaryschooleconomics]

night shifts... bad setup for trying to keep family together
although, try to tell your spouse when you are graduating from UCSF RadOnc residency that the only interview you've got is one for assistant professor position in Louisville

Hmm, this joke hits incredibly close to my reality.

 

[medgator]

Pretty sure the Emory Twitter account must have just woken up from 2007

 

[fiji128]

This Emory account is ridiculous. Sounds like Emory is a true head in the sand type of program. Just recruit more aggressively and fill and everything will be fine! Don't attack us because we want to fill our 16 spots at all cost so our department can maintain the veneer of academic prestige. If every program cuts one spot we would be training 700 residents every 4 years instead of 800. It would be at least a start.

This type of thinking might help explain why recent matches have been so difficult for Emory. FWIW I know someone in PP in Macon GA. I don't think that group has hired anyone new in about 5 years.

 

[Ray D. Ayshun]

This Emory account is ridiculous. Sounds like Emory is a true head in the sand type of program. Just recruit more aggressively and fill and everything will be fine! Don't attack us because we want to fill our 16 spots at all cost so our department can maintain the veneer of academic prestige. If every program cuts one spot we would be training 700 residents every 4 years instead of 800. It would be at least a start.

This type of thinking might help explain why recent matches have been so difficult for Emory. FWIW I know someone in PP in Macon GA. I don't think that group has hired anyone new in about 5 years.


View attachment 334794

Perhaps one of this year's grads signed at Mcaon, GA (know nothing about it), but Emory hasn't exactly been loading up small towns with well-trained docs, unless you count all those coastal cities in NC, SC, and GA...

Alumni | Emory School of Medicine

I can think of at least 1 alum that might have a different opinion.

 

[GapCalc]

Ah yes, the ol’ “superstar” praise. I remember this well from one of my particularly lazy attendings, who would frequently throw around this term in an effort to get residents to write worthless database reviews, and subsequently not write any meaningful comments before submission.

“Just think, this could get into JAMA Oncology and you would be *jazz hands* a SUPERSTAR!”

Guy didn’t lift a finger to help me find a job.

 

[thecarbonionangle]

Ah yes, the ol’ “superstar” praise. I remember this well from one of my particularly lazy attendings, who would frequently throw around this term in an effort to get residents to write worthless database reviews, and subsequently not write any meaningful comments before submission.

“Just think, this could get into JAMA Oncology and you would be *jazz hands* a SUPERSTAR!”

Guy didn’t lift a finger to help me find a job.

Sounds like a classic catfish RO

 

[RickyScott]

Sounds like a classic catfish RO

I prefer radonc rockstars.

 

[CurbYourExpectations]

Emory resident sarcastically asked if cutting spots would help with the oversupply.

...yes.

 

[OTN]

Most of us on this board didn't have to fight to preserve our market influence and power as physicians. We already have jobs, aren't going anywhere, etc. I know I'm not.

What I wanted was to try to help preserve what we had for future medical students/residents, so they could enjoy the choice of location and variety of job opportunities I did.

I never thought I would see residents themselves fighting against what we are doing. Their arguments are ridiculous on their face. I had to check several times to make sure the Emory Radonc Residents Twitter account wasn't a parody account. Unfortunately, no. What it is, is evidence of either someone with a proverbial gun held to their head, or someone with severe Stockholm Syndrome.

 

[TheWallnerus]

Ah yes, the ol’ “superstar” praise. I remember this well from one of my particularly lazy attendings, who would frequently throw around this term in an effort to get residents to write worthless database reviews, and subsequently not write any meaningful comments before submission.

“Just think, this could get into JAMA Oncology and you would be *jazz hands* a SUPERSTAR!”

Guy didn’t lift a finger to help me find a job.

 

[thecarbonionangle]

Most of us on this board didn't have to fight to preserve our market influence and power as physicians. We already have jobs, aren't going anywhere, etc. I know I'm not.

What I wanted was to try to help preserve what we had for future medical students/residents, so they could enjoy the choice of location and variety of job opportunities I did.

I never thought I would see residents themselves fighting against what we are doing. Their arguments are ridiculous on their face. I had to check several times to make sure the Emory Radonc Residents Twitter account wasn't a parody account. Unfortunately, no. What it is, is evidence of either someone with a proverbial gun held to their head, or someone with severe Stockholm Syndrome.

Likely the latter plus anxiety, self preservation about having less residents which will lead to more call and scut. This is the way at many places and why cutting spots is not enough but other measures must be taken to protect residents as many places will just make people double/triple cover

 

[fiji128]

Real talk, I think Emory was at 12 residents circa 2010. Now they are at 16 only ten years later. This despite a decreasing foot print and utilization of rad onc with waning medical student interest for obvious reasons. Now they claim letting go of even just 1 spot simply makes no sense and they have no problem filling via SOAP or whatever means necessary. Total garbage program that does not care about the long term health of the field.

 

[Mandelin Rain]

When the boat is taking on water, always refuse to bail. What good would it do? Just lather up in Irish Spring and go down with the ship.

 

[thecarbonionangle]

When the boat is taking on water, always refuse to bail. What good would it do? Just lather up in Irish Spring and go down with the ship.

As the titanic sunk, the fiddlers serenated the crowd. Some rats jumped ship but many sunk with it. Some floated around and the sharks feasted. It always repeats itself

 

[medgator]

 

[SubserviantToABR]

I don't know who is running this Emory twitter account, but whoever it is really needs to chill out. They're putting their colleagues at risk when they start looking for jobs and have Emory on their CV, which is now associated with these idiotic posts. News flash, there are plenty of residents, no practice needs to have an Emory grad at all.

 

[OTN]

Railing on 30 Gy in 10 fractions for palliation, while meanwhile on the Emory proton therapy web page, they claim benefit for breast cancer, prostate cancer, rectal cancer, etc...

Emory Proton Therapy Center

Advanced proton therapy—extreme precision, less radiation—at the Southeast's largest center: Emory Proton Therapy Center

winshipcancer.emory.edu

 

[RickyScott]

Railing on 30 Gy in 10 fractions for palliation, while meanwhile on the Emory proton therapy web page, they claim benefit for breast cancer, prostate cancer, rectal cancer, etc...

Emory Proton Therapy Center

Advanced proton therapy—extreme precision, less radiation—at the Southeast's largest center: Emory Proton Therapy Center

winshipcancer.emory.edu

Yip, hypofract gives them moral cover to charge 100k-or whatever they want-, and push protons, while using the convenience aspect of hyopfrac as a competitive advantage.