Rad Onc Twitter

[GuitarMan123]

While I applaud Dr. Chowdhary for this- and it certainly will have more impact than any of my research- I hope after this publication we can move on from the “did we expand too much” question to the far-more-important “what now?”

Actually, "Dr. Chowdhary" sadly only publishes things like this because he tries to publish anything he can. He basically only publishes NCDB research with Kirtesh Patel because they both lack access to doing real research. Just scraping the bottom of the barrel and republishing the same thing at lower and lower impact journals. He, similar to Fumiko Chino, #financialtoxicity#womenwhocurie#virtue, are only interested to make their names by publishing on crap like this because publishing real scientific research with real results requires science and hard work

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[RickyScott]

Actually, "Dr. Chowdhary" sadly only publishes things like this because he tries to publish anything he can. He basically only publishes NCDB research with Kirtesh Patel because they both lack access to doing real research. Just scraping the bottom of the barrel and republishing the same thing at lower and lower impact journals. He, similar to Fumiko Chino, #financialtoxicity#womenwhocurie#virtue, are only interested to make their names by publishing on crap like this because publishing real scientific research with real results requires science and hard work

I appreciate Dr Chowdhurys publication even though it is formalizing the obvious, but it needs to be done to counter the data driven idiot with objections like “where is the data that doubling residency numbers actually doubles the supply of residents” (we have plenty of this species of ***** in the field) Almost no one with full time clinical schedule can be engaged in real science.
In contrast, Dr Chino is dishing out financial toxicity daily with the worlds most expensive radiation oncology rates. She does not seem to reach the obvious conclusion that the more MSKCC expands, the larger the financial toxicity!

 

[deleted774703]

Actually, "Dr. Chowdhary" sadly only publishes things like this because he tries to publish anything he can. He basically only publishes NCDB research with Kirtesh Patel because they both lack access to doing real research. Just scraping the bottom of the barrel and republishing the same thing at lower and lower impact journals. He, similar to Fumiko Chino, #financialtoxicity#womenwhocurie#virtue, are only interested to make their names by publishing on crap like this because publishing real scientific research with real results requires science and hard work

when did Ralph W join SDN?

 

[evilbooyaa]

Actually, "Dr. Chowdhary" sadly only publishes things like this because he tries to publish anything he can. He basically only publishes NCDB research with Kirtesh Patel because they both lack access to doing real research. Just scraping the bottom of the barrel and republishing the same thing at lower and lower impact journals. He, similar to Fumiko Chino, #financialtoxicity#womenwhocurie#virtue, are only interested to make their names by publishing on crap like this because publishing real scientific research with real results requires science and hard work

I'm not sure what your beef with Dr. Chowdhary is but his publications and vocalness on the impact of the job market on residents is very much appreciated in my eyes.

Him and Chelain Goodman are the main current rad onc residents I think of that get their drinks bought by me if I ever run into them.

Sounds like you've got a massive inferiority complex to me.

I especially like how you put his name in quotes similar to how twitter folks talk about SDN "doctors".

 

[evilbooyaa]

It’s cool that they are solving the rural maldistribution problem by opening the most programs in top-10 metros.

That's not really what they said.

Annual growth rates in RO programs & positions were not statistically different between the major metropolitan locations vs. all others.

It's to say that more programs are opening up based on region of the country (north east, south, and west growing at higher rates than midwest) without finding any differences based on population. Obviously as small programs expand, there will become less small programs.

 

[PhotonBomb]

 

[Burt Radnolds]

There is a massive truth void currently in the world of rad onc academia. A few may be be able to make quite the career out of stepping into the light and laying our specialties inadequacies and missteps bare. When the truth is on your side you can become unstoppable. Nevermind the fact that it is pathetic that it takes the possibility of career advancement to do the right thing, but hey I'm a results guy and so is most of society

 

[medgator]

Online access to pro and IJROBP online has been awful lately, won't let me look at any of the articles, used to not be a problem before when going through the ASTRO site

 

[Haybrant]

I’ve been nice a lot but RW is an absolute idiot; that last tweet exchange again shows how academicians are not leaders and influencers just bc they are high on the academic totem pole. RW is bottom barrel in his views on this important topic. Really cements how we at SDN are the true voices of this mess, not people like RW.

 

[PhotonBomb]

I’ve been nice a lot but RW is an absolute idiot; that last tweet exchange again shows how academicians are not leaders and influencers just bc they are high on the academic totem pole. RW is bottom barrel in his views on this important topic. Really cements how we at SDN are the true voices of this mess, not people like RW.

Omg this is parody

 

[Krukenberg]

Actually, "Dr. Chowdhary" sadly only publishes things like this because he tries to publish anything he can. He basically only publishes NCDB research with Kirtesh Patel because they both lack access to doing real research. Just scraping the bottom of the barrel and republishing the same thing at lower and lower impact journals. He, similar to Fumiko Chino, #financialtoxicity#womenwhocurie#virtue, are only interested to make their names by publishing on crap like this because publishing real scientific research with real results requires science and hard work

really not cool to attack one of the few residents putting their name on the line to shine a light on expansion. Not everyone can be at a department with a wealth of resources and he’s been very productive as a resident. You act like residents have prospective trials completing on the reg...

 

[PleaseRemainCalm]

Actually, "Dr. Chowdhary" sadly only publishes things like this because he tries to publish anything he can. He basically only publishes NCDB research with Kirtesh Patel because they both lack access to doing real research. Just scraping the bottom of the barrel and republishing the same thing at lower and lower impact journals. He, similar to Fumiko Chino, #financialtoxicity#womenwhocurie#virtue, are only interested to make their names by publishing on crap like this because publishing real scientific research with real results requires science and hard work

Based on your post history there is a chance you are this guy's peer but since this is a forum of mostly attendings it is just a bad look to publicly name and shame a resident like that.

 

[elementaryschooleconomics]

really not cool to attack one of the few residents putting their name on the line to shine a light on expansion. Not everyone can be at a department with a wealth of resources and he’s been very productive as a resident. You act like residents have prospective trials completing on the reg...

There are so few people willing to even come out with "neutral tone" manuscripts on expansion that every last one should be applauded. Most of us here have strong opinions on the topic yet virtually none of us will attach our real names to those opinions out of fear of career retribution.

Royce, Chowdhary etc are some of the "good guys" in this fight and certainly don't deserve to have their body of work attacked. I say this as someone who publishes almost exclusively in the bench-based laboratory world: medicine moves forward when research is conducted and papers published on every aspect of the biomedical enterprise.

Not everyone should be a pipette jockey.

 

[thecarbonionangle]

its sad that our specialty has such a dearth of leadership that publishing and stating the obvious, making a career out of it is some sort of revolutionary idea. Cheers to those sticking neck out, as most are like turtles in our world. Come up for air and retreat to the dark depths beneath the swamp. DRAIN THE SWAMP

 

[elementaryschooleconomics]

its sad that our specialty has such a dearth of leadership that publishing and stating the obvious, making a career out of it is some sort of revolutionary idea. Cheers to those sticking neck out, as most are like turtles in our world. Come up for air and retreat to the dark depths beneath the swamp. DRAIN THE SWAMP

I swear our specialty attracts the most conflict-averse people in all of medicine. Can we study that? I obviously don't know much about other specialties but my IM intern year felt filled with people ready to go to war - let alone my experience with surgery in medical school.

I actually had the opposite experience when working through my PhD - those folks were BRUTAL. This is one of my favorite pieces I came across:

Are we training pit bulls to review our manuscripts?

That was part of the MD-PhD career path I've had difficulty with. On one hand, to obtain my PhD I literally had to "defend" my work while people told me how stupid I was. Then I switch back over the being a physician and every day it's a minefield to avoid stepping on toes because someone thinks I spoke in "too harsh of a tone".

 

[thecarbonionangle]

I swear our specialty attracts the most conflict-averse people in all of medicine. Can we study that? I obviously don't know much about other specialties but my IM intern year felt filled with people ready to go to war - let alone my experience with surgery in medical school.

I actually had the opposite experience when working through my PhD - those folks were BRUTAL. This is one of my favorite pieces I came across:

Are we training pit bulls to review our manuscripts?

That was part of the MD-PhD career path I've had difficulty with. On one hand, to obtain my PhD I literally had to "defend" my work while people told me how stupid I was. Then I switch back over the being a physician and every day it's a minefield to avoid stepping on toes because someone thinks I spoke in "too harsh of a tone".

Said it before on here but specialty would benefit from more of these “go to war” personalities rather than appeasers. More Churchills and less Chamberlains. Surgery departments in some of the top places are the best programs because these people do not back down

 

[GapCalc]

From the Tendulkar paper linked above:

"We acknowledge that an information asymmetry exists, and that the viewpoints expressed by those on online message boards should not be summarily dismissed.[13]"

Nice.

 

[GapCalc]

Regarding the ABR fiasco:

"Because the Angoff method is designed to assess the likelihood of a “minimally qualified” performer to answer test questions correctly, one suggestion to improve the applicability of board examinations to real-life patient care would be to limit the process of exam question selection and Angoff scoring to radiation oncologists in general clinical practice."

What a breath of fresh air. Can't wait for cranky Grandpa Ralph to weigh in on this.

 

[PhotonBomb]

please post whole article

so many programs need to be put DOWN.

 

[elementaryschooleconomics]

please post whole article

so many programs need to be put DOWN.

Here's the whole article

 

[RadOncMegatron]

Regarding the ABR fiasco:

"Because the Angoff method is designed to assess the likelihood of a “minimally qualified” performer to answer test questions correctly, one suggestion to improve the applicability of board examinations to real-life patient care would be to limit the process of exam question selection and Angoff scoring to radiation oncologists in general clinical practice."

What a breath of fresh air. Can't wait for cranky Grandpa Ralph to weigh in on this.

RW strikes again! Though I respect the man very very much, this Tweet...




I swear I am high volume for Peds, Gyn, Breast, HN, Lung, Sarcoma, Prostate, GU, Lymphoma, Skin, promise! Except TBI and Total Skin e- I suck really really bad at those and cord compressions on Friday - Sunday. Feel free to take those!

 

[Haybrant]

RW strikes again! Though I respect the man very very much, this Tweet...




I swear I am high volume for Peds, Gyn, Breast, HN, Lung, Sarcoma, Prostate, GU, Lymphoma, Skin, promise! Except TBI and Total Skin e- I suck really really bad at those and cord compressions on Friday - Sunday. Feel free to take those!View attachment 287814

again RW is as guilty as for what he accuses SDN posters of doing. Making a bold claim and when pushed having no real thoughts about achieving stated goals, his follows ups are always incredibly flat. Interesting to see him tarnish his own reputation and his institutions

 

[RadOncMegatron]

"we suggest that self-reflection by individual programs will be prudent to assess whether to voluntarily reduce a program’s overall complement (e.g. selecting to not participate in the SOAP), or potentially face the prospect of involuntarily downsizing or closing altogether in the coming years if medical student interest plummets... Bates et al speculate that “clinical service work during residency is a major reason for the expansion of the resident workforce,”

Exactly. Kudos to the authors for explicitly saying what needs to be said.

 

[PhotonBomb]

again RW is as guilty as for what he accuses SDN posters of doing. Making a bold claim and when pushed having no real thoughts about achieving stated goals, his follows ups are always incredibly flat. He’s terrrible and should not be looked up to, funny to see him tarnish his own reputation and his institutions

I agree dumb tweet but fairly certain he’s never said anything about SDN lol. You have a real victim persona.

 

[OTN]

RW strikes again! Though I respect the man very very much, this Tweet...




Seeing as how I carry 2-3x the patient load of the vast majority of academics I know, those who agree with him will be sending patients my way soon, right?

I swear I am high volume for Peds, Gyn, Breast, HN, Lung, Sarcoma, Prostate, GU, Lymphoma, Skin, promise! Except TBI and Total Skin e- I suck really really bad at those and cord compressions on Friday - Sunday. Feel free to take those!View attachment 287814

 

[RadOncDoc21]

Does dude have CTE?

RW strikes again! Though I respect the man very very much, this Tweet...




I swear I am high volume for Peds, Gyn, Breast, HN, Lung, Sarcoma, Prostate, GU, Lymphoma, Skin, promise! Except TBI and Total Skin e- I suck really really bad at those and cord compressions on Friday - Sunday. Feel free to take those!View attachment 287814

 

[medgator]

RW strikes again! Though I respect the man very very much, this Tweet...




I swear I am high volume for Peds, Gyn, Breast, HN, Lung, Sarcoma, Prostate, GU, Lymphoma, Skin, promise! Except TBI and Total Skin e- I suck really really bad at those and cord compressions on Friday - Sunday. Feel free to take those!View attachment 287814

What a tool....

 

[medgator]

RW strikes again! Though I respect the man very very much, this Tweet...




I swear I am high volume for Peds, Gyn, Breast, HN, Lung, Sarcoma, Prostate, GU, Lymphoma, Skin, promise! Except TBI and Total Skin e- I suck really really bad at those and cord compressions on Friday - Sunday. Feel free to take those!View attachment 287814

We stopped doing TSE, wasn't cost effective sadly given the staff and linac time involved.

I'm sure the nci designated center is making a killing on that too compared to everyone else

 

[thecarbonionangle]

These old senile boomers need to retire and take their memantine.

 

[OTN]

We stopped doing TSE, wasn't cost effective sadly given the staff and linac time involved.

I'm sure the nci designated center is making a killing on that too compared to everyone else

We do both TSET and TBI at my practice. Huge pain, but worth the effort to be able to truly say we do it all.

 

[RadOncMegatron]

Ok is the situation this bad? Dr. Peedell had to write a LONG tweetorial defending SBRT lung outside of academic institutions. Are we really going to do this? I really don't want a PP vs Academics situation (if we aren't already there yet). It's not like the PP folks don't have dirt on the academic centers. Respect needs to flow both ways.

 

[elementaryschooleconomics]

I really wish someone would convince Weichselbaum to get off of Twitter. All he's doing at this point is tarnishing his legacy and giving credence to gossip that Chicago is a malignant place.

ALL curative radiotherapy should be done in high volume centers? I just don't even know where to begin with that statement.

I enjoyed this:

"Don't know what else to say"?

That pretty much sums up every single one of his Tweets. They basically follow this format:

Original Tweet: *says something about anything*

RW Response: *provocative statement with little to no evidence or justification*

 

[Mandelin Rain]

Multidisciplinary care at a high level?

"You going to give chemo? Yes. Great. What about durva after? Yes? Perfect."

Mission accomplished!

What a twit. Get out of the lab and treat someone guy. It's not that hard after a 4 year residency.

 

[metallica81788]

RW appears to be the Gary Busey of radiation oncology.

 

[elementaryschooleconomics]

Wow, RW being really generous here, graciously admitting community docs can probably handle palliative treatments:

 

[evilbooyaa]

I thought UChicago had made him stop tweeting.

Somebody let grandpa on the computer again!

 

[medgator]

Wow, RW being really generous here, graciously admitting community docs can probably handle palliative treatments:

View attachment 287837

He just keeps digging that hole deeper



Has this guy ever prescribed a standard course of curative radiation in h&n? Honest question.. Good luck getting a patient to travel 6-7 weeks for that

 

[medgator]

From the Tendulkar paper linked above:

"We acknowledge that an information asymmetry exists, and that the viewpoints expressed by those on online message boards should not be summarily dismissed.[13]"

Nice.

The irony of that, considering KO is one of the authors....



Glad to see SDN is dishing out lots of crow this year...

 

[PhotonBomb]

I thought UChicago had made him stop tweeting.

Somebody let grandpa on the computer again!

I think this is the correct way to view it. He’s clearly super old and out of touch and probably has no real power or say at UChicago. I don’t take any of his tweets as anything but entertainment.

 

[elementaryschooleconomics]

I think this is the correct way to view it. He’s clearly super old and out of touch and probably has no real power or say at UChicago. I don’t take any of his tweets as anything but entertainment.

Are you assuming being the chair of Chicago is a figurehead position? That seems dubious...I don't know about your experience, but in mine, department chairs are generally God.

 

[Gfunk6]

I'm very glad RW opined on this topic. To be honest, I'm not sure my residency really equipped me to handle AP/PA palliative spine and whole brain treatments. Guess I'll be referring them all to UCSF and Stanford now.

 

[medgator]

I think this is the correct way to view it. He’s clearly super old and out of touch and probably has no real power or say at UChicago. I don’t take any of his tweets as anything but entertainment.

I would agree with you if he was chair emeritus. Doesn't appear to be the case...

 

[KHE88]

Wow, RW being really generous here, graciously admitting community docs can probably handle palliative treatments:

View attachment 287837

As incredibly offensive, elitist, and classist as this astonishingly ignorant 'tweet' of Weichselbaum's is (and for something which an apology is really warranted), it's really not even worth dignifying with a serious response. What we are witnessesing is someone on a rapid decline. An intervention is needed.

 

[scarbrtj]

He just keeps digging that hole deeper



Has this guy ever prescribed a standard course of curative radiation in h&n? Honest question.. Good luck getting a patient to travel 6-7 weeks for that

"The data simply does not support full spectrum rad onc practice any more than it does full spectrum surgery."

So why full spectrum residency training? Guess we need like one or two years of rad onc followed, by, like a 2-3y breast rad onc fellowship e.g. THE DATA SUPPORTS this approach after all. Yeesh.

 

[deleted774703]

"The data simply does not support full spectrum rad onc practice any more than it does full spectrum surgery."

So why full spectrum residency training? Guess we need like one or two years of rad onc followed, by, like a 2-3y breast rad onc fellowship e.g. THE DATA SUPPORTS this approach after all. Yeesh.

RW is truly out of his mind these days lol

 

[deleted774703]

The irony of that, considering KO is one of the authors....



Glad to see SDN is dishing out lots of crow this year...

very nice editorial. Highly doubt KO was the one to put that specific sentence in there though lol

wonder if he tried to edit it out though...

 

[Haybrant]

RW is truly out of his mind these days lol

I’m rethinking my thoughts about him actually. He’s not out of his mind as much as I thought. He like many outside this board, are years behind in the debate and are going through the same steps that many of us were 3-4 years ago. So to us it sounds crazy but he like KO and many of the other are just very very behind in the discussion, we’re well beyond thinking that rad onc is a single site specialty, I remember having this conversation here years ago

 

[deleted774703]

I’m rethinking my thoughts about him actually. He’s not out of his mind as much as I thought. He like many outside this board, are years behind in the debate and are going through the same steps that many of us were 3-4 years ago. So to us it sounds crazy but he like KO and many of the other are just very very behind in the discussion, we’re well beyond thinking that rad onc is a single site specialty, I remember having this conversation here years ago

That’s possible. Very smart researcher but his goals seem to be only in 1 direction

needs to spend more time with avg ppl lol

 

[RadOncDoc21]

All American cancer patients should only receive their treatments at Cancer Treatment Centers of America! I say we stop following this guy even if it’s to post his nonsense.

 

[PhotonBomb]

The PRO article implies that programs that try to go against the grain and try to expand or SOAP year after year will only further a self-fulfilling process and it will make it harder and harder for them to match.

I agree with this for sure. On the google doc people are questioning Case for wanting to expand in this climate. talk about self-sabotage

Good luck Case, you filthy animals!

You guys ever see Mitch Machtay try to put a note in himself?