Haybrant

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Does he do these messages in the evening or night? That may point to alcohol related behavior. I’ve also heard he’s not the most pleasant in real life.

Oh, and what do you mean “greats”? What has he done that would make you say he is great? Not that prolific publication-wise, and no big studies or anything practice changing (though, who is doing anything practice changing in our field?)
not many people do a bang up job of standing up to the bully surgeons and the holier than thou prolong life 1 month med oncs - drew does. That’s how Valor got through. Just have no idea how acting as a bully to younger gen (one that is on the correct side of history at that) benefits him one bit, like even a single ounce.
 
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elementaryschooleconomics

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This is a nonsensical Tweet -

1) This snapshot of a single slide does not give any indication of quality
2) If some other part of the presentation did, why not give us a snapshot of that slide?
3) Just looking at the 4-5 year trend of RadOnc residencies is not adequate

...and then, assuming the worst case scenario -

4) Is he honestly asserting that going from 825 to 817 spots in one year is "moving in the right direction"? That's within one standard deviation:

1583162661990.png

#radoncrocks
 

elementaryschooleconomics

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This is a nonsensical Tweet -

1) This snapshot of a single slide does not give any indication of quality
2) If some other part of the presentation did, why not give us a snapshot of that slide?
3) Just looking at the 4-5 year trend of RadOnc residencies is not adequate

...and then, assuming the worst case scenario -

4) Is he honestly asserting that going from 825 to 817 spots in one year is "moving in the right direction"? That's within one standard deviation:

View attachment 297300

#radoncrocks
I guess I should amend my statement to say that yes, going down is indeed moving in the right direction, but drawing any conclusions from this data is questionable at best and ignorant/malicious at worst.
 
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You're missing a very, very important point. It is going down. Tell me when the last time the total number went down. I think we can't constantly be looking at the "bad side" of things. I'm a pessimist, too, but this is an actual good thing. Look at the last 10 years, and let's be somewhat objective.
 

Neuronix

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You're missing a very, very important point. It is going down. Tell me when the last time the total number went down. I think we can't constantly be looking at the "bad side" of things. I'm a pessimist, too, but this is an actual good thing. Look at the last 10 years, and let's be somewhat objective.
I try to look on the bright side of life too, but I'm not going to cheer a less than 1% reduction.
 
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elementaryschooleconomics

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You're missing a very, very important point. It is going down. Tell me when the last time the total number went down. I think we can't constantly be looking at the "bad side" of things. I'm a pessimist, too, but this is an actual good thing. Look at the last 10 years, and let's be somewhat objective.
Totally agree that it's important to acknowledge that any reduction, no matter how small, is important.

However, I am trying to remain objective - I cannot draw any conclusions with numbers within 1 standard deviation of the mean. I think drawing conclusions from the presented data in either direction is premature right now. The data is the data - I don't know what this means in the greater context, and importantly, no one else does either.
 
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OTN

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A drop in # of approved residents is great!

However, "...with focus on quality" is actually an affront to the current radonc residents, who apparently weren't quality residents. (Shrug emoji)
 
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Agree that "with focus on quality" means nothing.

But, to minimize the fact that we finally have a decrease rather than an increase (or even stable) DESPITE the slow rate of change seems to be an example of "perfect being the enemy of good". And, at this point, I hope we can get off the hater horse for like, uh, 5 minutes?
 
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elementaryschooleconomics

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Agree that "with focus on quality" means nothing.

But, to minimize the fact that we finally have a decrease rather than an increase (or even stable) DESPITE the slow rate of change seems to be an example of "perfect being the enemy of good". And, at this point, I hope we can get off the hater horse for like, uh, 5 minutes?
Cal Pacific closes. MDACC and Harvard reduce compliment by 1 each.

[hangs “Mission Accomplished” banner]
No, don't ever take your foot off the gas, that's how you lose.

As Mandelin pointed out, CPMC closed. That's 4 spots out of the 8. Half of the reduction.

4 spots actually reduced out of 825 is a 0.48% reduction with some sort of intent (the 2 from Anderson and Harvard at least).

Best case scenario, all 4 of of those spots were consciously reduced out of concern for oversupply, which is action that should absolutely be recognized.

My "hater horse" is galloping towards the sound of a Program Director virtue signaling on Twitter in the middle of an academic year about a 0.48% reduction (note how the slide specifically states Feb 2020).

I have born witness to a metric ton of academic placating in my life and this reeks of it.
 

scarbrtj

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This is a nonsensical Tweet -

1) This snapshot of a single slide does not give any indication of quality
2) If some other part of the presentation did, why not give us a snapshot of that slide?
3) Just looking at the 4-5 year trend of RadOnc residencies is not adequate

...and then, assuming the worst case scenario -

4) Is he honestly asserting that going from 825 to 817 spots in one year is "moving in the right direction"? That's within one standard deviation:

View attachment 297300

#radoncrocks
Another way to look at it is:
'17 vs '16: 1.6% increase
'18 vs '17: 1.6% increase
'19 vs '18: 0.4% increase
That's a std dev of about 0.7. So a 825 to 817 drop for '20 vs '19, a -1% drop (or 1% drop? hmm), is a bit of an outlier and ~2 std devs away. Again depending on how you look at it. Especially if we were to factor in years prior to 2016. But that's the thing about a single outlier. Is it the start of a trend, or just simply a one-off? However, if we were producing widgets and were expecting ~1.6% daily production rates, a -1% production rate on a single day would be enough to halt the assembly line.
 

elementaryschooleconomics

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Another way to look at it is:
'17 vs '16: 1.6% increase
'18 vs '17: 1.6% increase
'19 vs '18: 0.4% increase
That's a std dev of about 0.7. So a 825 to 817 drop for '20 vs '19, a -1% drop (or 1% drop? hmm), is a bit of an outlier and ~2 std devs away. Again depending on how you look at it. Especially if we were to factor in years prior to 2016. But that's the thing about a single outlier. Is it the start of a trend, or just simply a one-off? However, if we were producing widgets and were expecting ~1.6% daily production rates, a -1% production rate on a single day would be enough to halt the assembly line.
"A patient presents to the ED with a cough, a CXR shows a new nodule. What do you do?"

"Ask to see prior imaging."

I will be OVERJOYED to eat my words in a year or two about this, if this is the start of a trend.
 
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Cal Pacific closes. MDACC and Harvard reduce compliment by 1 each.

[hangs “Mission Accomplished” banner]
Did Augusta/Regents/MCG/whatever-their-current-name-is-now close yet? If not why? It was literally a freestanding center. Private practices should not have residencies and should never have been approved in the first place.
 

PhotonBomb

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Agree that "with focus on quality" means nothing.

But, to minimize the fact that we finally have a decrease rather than an increase (or even stable) DESPITE the slow rate of change seems to be an example of "perfect being the enemy of good". And, at this point, I hope we can get off the hater horse for like, uh, 5 minutes?
I would hope he means focus on quality of programs which is an importnet tning
 
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"A patient presents to the ED with a cough, a CXR shows a new nodule. What do you do?"

"Ask to see prior imaging."

I will be OVERJOYED to eat my words in a year or two about this, if this is the start of a trend.
Look, I get that the naysayers are going to nay say. Like Scarb says, you go from positive growth for >10 years and then you suddenly go to negative and then .. "BUT ITS NOT ENOUGH!!!"

Be realistic. We will not get to 0 residents by 2021, Alligator style. If you don't see this as positive change, you're either not trying or you're always going to look for the negative. Next year we probably will be 25-50 spots less, and then you'll hear "Well, it should be a 100 spots less".

This is a big deal.
 

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Next year we probably will be 25-50 spots less, and then you'll hear "Well, it should be a 100 spots less".

This is a big deal.
IMO, when 25-50 less (or totally unfilled) spots happens, it will be a big deal. Let's see.
 
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Look, I get that the naysayers are going to nay say. Like Scarb says, you go from positive growth for >10 years and then you suddenly go to negative and then .. "BUT ITS NOT ENOUGH!!!"

Be realistic. We will not get to 0 residents by 2021, Alligator style. If you don't see this as positive change, you're either not trying or you're always going to look for the negative. Next year we probably will be 25-50 spots less, and then you'll hear "Well, it should be a 100 spots less".

This is a big deal.
Need to see consistent downward trend before more optimism. This is more of a leveling off
 
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jkdoctor

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Look, I get that the naysayers are going to nay say. Like Scarb says, you go from positive growth for >10 years and then you suddenly go to negative and then .. "BUT ITS NOT ENOUGH!!!"

Be realistic. We will not get to 0 residents by 2021, Alligator style. If you don't see this as positive change, you're either not trying or you're always going to look for the negative. Next year we probably will be 25-50 spots less, and then you'll hear "Well, it should be a 100 spots less".

This is a big deal.
Lmao. PDs and chairs are like pigs at the trough. They will keep filling themselves with new residents without regards for the future. They will not care if they are filling up on corn (US MDs), wheat (US DOs), potatoes (IMGs), or apples (FMGs).
1583331901337.png
 

Mandelin Rain

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Dropping 8 spots is better than adding 8 spots, no doubt.

I think it would be a REALLY tough sell to expand in this environment due to the tireless work done here, so let's congratulate no one but ourselves for at least stabilizing the number.

My question, is the drop in 8 spots permanent or is it due to two of our best institutions temporarily agreeing to lower their compliment by one and a few residencies with 6 or 10 residents cycling to "take 1 this year" rather than "take 2 this year", that will cycle back the opposite way next year?

The only permanent decrease that comes to mind is Cal Pacific, but perhaps I'm missing some?????
 
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scarbrtj

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Lmao. PDs and chairs are like pigs at the trough. They will keep filling themselves with new residents without regards for the future. They will not care if they are filling up on corn (US MDs), wheat (US DOs), potatoes (IMGs), or apples (FMGs).
View attachment 297541
PDs and chairs eat one thing and one thing only: soylent green.
 

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Don’t knock soylent - that stuff is so good. There was a point in time where I saw both internists and surgeons show up to tumor board with a bottle in their pocket, haha
 

evilbooyaa

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Dropping 8 spots is better than adding 8 spots, no doubt.

I think it would be a REALLY tough sell to expand in this environment due to the tireless work done here, so let's congratulate no one but ourselves for at least stabilizing the number.

My question, is the drop in 8 spots permanent or is it due to two of our best institutions temporarily agreeing to lower their compliment by one and a few residencies with 6 or 10 residents cycling to "take 1 this year" rather than "take 2 this year", that will cycle back the opposite way next year?

The only permanent decrease that comes to mind is Cal Pacific, but perhaps I'm missing some?????
Hannehman as well going forward.
 
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Carotenoid

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But physicians have a responsibility to their patients and if a section head or department chair is pressuring docs to ask patients to unnecessarily commute longer distances to receive the same care available to them closer to their home or to forego evidence based guidelines (active surveillance), we have a real issue. This was a request from a physician in leadership, not an admin.
Physician who goes into leadership... probably becomes an admin ;)
 
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scarbrtj

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The extent that rad oncs can't do stuff or won't even think about stuff without GUIDELINES strikes me as weird. If some really previously totally never-before-happened things happen, like packs of stray wild dogs controlling most cities in North America, hope a pack of stray wild rad oncs writes us some guidelines. It's so hard to know what to do without guidelines :(
I kind of agree with this.

The thing is it’s so hard to keep up on literature and make your own conclusions.
 

scarbrtj

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I kind of agree with this.

The thing is it’s so hard to keep up on literature and make your own conclusions.
And for the most part sir I agree with you. (I even liked the articles e.g. about how Puerto Rican rad onc depts were dealing with the hurricane disaster a couple years back.) However, if rad oncs for some strange reason started getting broken down automobiles and finding themselves stranded in the middle of nowhere en masse, look for in Red Journal: "Car Trouble at Night: Practical Indications for Getting Home." But anyways as you know I'm inveterately irreverent. Or maybe irreverently inveterate.
 
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The extent that rad oncs can't do stuff or won't even think about stuff without GUIDELINES strikes me as weird. If some really previously totally never-before-happened things happen, like packs of stray wild dogs controlling most cities in North America, hope a pack of stray wild rad oncs writes us some guidelines. It's so hard to know what to do without guidelines :(
Can’t win with the truckas like you.

Yesterday : Why ARENT THERE ANY GUIDELINES ON THIS ASTRO LAZY AND SLEEP.

TODAY: RAD ONCS ARE DUMB THEY NEED GUIDELINES FOR EVERYTHING.

Ignoring real life events for a second that we may or may know about you, you’ve ruined your own credibility on this website multiple times.
 
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scarbrtj

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Can’t win with the truckas like you.

Yesterday : Why ARENT THERE ANY GUIDELINES ON THIS ASTRO LAZY AND SLEEP.

TODAY: RAD ONCS ARE DUMB THEY NEED GUIDELINES FOR EVERYTHING.

Ignoring real life events for a second that we may or may know about you, you’ve ruined your own credibility on this website multiple times.
I said ASTRO should release a guideline to give afflatus to good sense? Hmm no. But hey I'm glad I fascinate you so. You certainly flatter me with much attention ;)
 
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Neuronix

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I want to reply: does your chief resident have a job? Mine doesn't. Three years running now, the chiefs I personally worked with are or have been in March and April with no job. Last year's graduated jobless.

But I don't want to post with my real name.



Post edited for clarity.
 
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I want to reply: does your senior resident have a job? Mine doesn't. Three years running now, our chiefs are or have been in March and April with no job. Last year seniors graduated jobless.

But I don't want to post with my real name.

There’s something deeply wrong with your program then. The job market is not what it used to be, but this is NOT close to the norm. We all know this.

What is wrong with your program do you think? Any theories?
 

Neuronix

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I'm not giving more details for anonymity sake. This is why I don't post under my real name: it just immediately gets personal against me, my department, or our residents.

Overall, I'm sticking to the truth that this is a rad onc wide problem. Your assertion that the job market is fine ("we all know this") is blatently false.

Find me another specialty in medicine except for pathology where it's like this. Grads from our institution in other specialties are being actively recruited out of the middle of their residencies and fellowships.
 
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I'm not giving more details for anonymity sake. This is why I don't post under my real name: it just immediately gets personal against me, my department, or our residents.

Overall, I'm sticking to the truth that this is a rad onc wide problem. Your assertion that the job market is fine ("we all know this") is blatently false.

Find me another specialty in medicine except for pathology where it's like this. Grads from our institution in other specialties are being actively recruited out of the middle of their residencies and fellowships.
Dude. An entire class graduating jobless and three years in row no jobs by April?

Sorry but this is NOT normal.

If you can’t see that, idk what to say

There’s a problem with the job market, but that’s insane.
 

RickyScott

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There’s something deeply wrong with your program then. The job market is not what it used to be, but this is NOT close to the norm. We all know this.

What is wrong with your program do you think? Any theories?
Chief residents today were aoa and 260+ even at the bottom programs. If this is taking place anywhere it is totally unacceptable.
 

Neuronix

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Dude. An entire class graduating jobless and three years in row no jobs by April?

Sorry but this is NOT normal.

If you can’t see that, idk what to say

There’s a problem with the job market, but that’s insane.
I didn't mean to imply that our entire classes went jobless or didn't have jobs in March/April. Just the seniors I am or were working with this time of year.
 

medgator

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There’s something deeply wrong with your program then. The job market is not what it used to be, but this is NOT close to the norm. We all know this.

What is wrong with your program do you think? Any theories?
What's right with yours?
 
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Find me another specialty in medicine except for pathology where it's like this. Grads from our institution in other specialties are being actively recruited out of the middle of their residencies and fellowships.
Med oncs being recruited 1st year of fellowship and given 100k signing bonus paid at time of signing. Seen it.
Med onc quality of life is not quite as good as ours, but still overall very good. Definitely top 10-20% in medicine, we just have the privilege of being top 1%. Job not quite as interesting and a little more taxing from a patient care/documentation standpoint, but again it's good.
Med oncs in practice constantly bombarded by job opportunities all over country with 500k+ salary guarantees. Rad Onc? Well hey that's that Sonora, CA job offering 500k that's been posted for a year now. What's the deal with that one? Obviously something awful. Literally the same 10 middle-of-nowhere crap jobs emailed to 4000 rad oncs for the past year.
 
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