Rad Onc Twitter

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medgator said:
@Dan Spratt ?? Pretty ballsy to be expanding a second fiddle program in a Midwest Metro imo
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This is the unfortunate position we find ourselves in. I’m sure Dan’s mom is very proud that he’s chair and they’ll have a decent training program, but the reality is expanding individual programs without contracting on a global level hurts the field.

Respect to MDA for contracting.
 
Doctorer said:
This is the unfortunate position we find ourselves in. I’m sure Dan’s mom is very proud that he’s chair and they’ll have a decent training program, but the reality is expanding individual programs without contracting on a global level hurts the field.

Respect to MDA for contracting.
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Cleveland clinic as well, which is arguably the premier program in the area, @Dan Spratt
 
thesauce said:
Ugh. I thought Spratt was one of those that understood the problem. I didn’t expect him to contribute to it.
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1667745782027.gif


Dude wrote long winded responses and seemed like a good politician but if you read deep into what he was saying, he wasn’t saying anything.
 
RealSimulD said:
100%

But I’m still not sure this is expansion
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Spots were expanded right before he took over iirc, correct? If so, nothing mandates him putting all 3 of those up for grabs. Anderson and CC simply chose to offer one less spot in the match last cycle right? Doing the right thing sounded pretty simple to me
 
medgator said:
Spots were expanded right before he took over iirc, correct? If so, nothing mandates him putting all 3 of those up for grabs. Anderson and CC simply chose to offer one less spot in the match last cycle right? Doing the right thing sounded pretty simple to me
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Agree!

But had zero expectation he would do that.
 
RadOnc training programs in my area (3 mediocre ones) are definitely feeling bullish
 
Interesting. I think I know where you are around and know folks at all 3 places. None are talking expansion … but maybe you know something I don’t.
 
Every additional radonc resident is potentially one less medical oncology fellow.

Every clinic in my rural region has fully staffed radonc clinic. New hires have been easy in past several years. I'm sure we could make do (maybe not ideally) if our work force was cut in half.

No clinic in my rural region has a fully staffed medonc clinic and many have been functioning without MO continuity for years.

I don't think it's ethical to expand radonc at present.
 
RealSimulD said:
Interesting. I think I know where you are around and know folks at all 3 places. None are talking expansion … but maybe you know something I don’t.
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No, not one of them 3 are applying for additional spots (god forbid). Management is just getting comfortable that they will keep approved spots filled and come closer to have a full complement.
 
Programs that have closed with approved resident spots prior to withdrawal of accreditation; Drexel in 2019 (4), Medical College of Georgia in 2019 (4), California Pacific in 2019 (4) and Cornell 2021 (6).

Programs to have officially increased spots from 2019 to 2021; Loma Linda 5 to 6, Case Western Reserve 6 to 7, Columbia 6 to 8, Northwestern 8 to 9, Thomas Jefferson 9 to 11, Duke 13 to 14.

Programs to have officially increased spots from 2021 to 2022; None.

Programs to have officially decreased spots from 2021 to 2022; None.

Several places have soft decreased spots such as MDACC, Colorado and Cleveland Clinic but not officially contracted them through the ACGME.
 
fiji128 said:
Programs that have closed with approved resident spots prior to withdrawal of accreditation; Drexel in 2019 (4), Medical College of Georgia in 2019 (4), California Pacific in 2019 (4) and Cornell 2021 (6).

Programs to have officially increased spots from 2019 to 2021; Loma Linda 5 to 6, Case Western Reserve 6 to 7, Columbia 6 to 8, Northwestern 8 to 9, Thomas Jefferson 9 to 11, Duke 13 to 14.

Programs to have officially increased spots from 2021 to 2022; None.

Programs to have officially decreased spots from 2021 to 2022; None.

Several places have soft decreased spots such as MDACC, Colorado and Cleveland Clinic but not officially contracted them through the ACGME.
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With the exception of perhaps, Duke, general trend is hellpits are expanding and good training programs are being good stewards of the field. Sounds like business as usual
 
medgator said:
With the exception of perhaps, Duke, general trend is hellpits are expanding and good training programs are being good stewards of the field. Sounds like business as usual
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For the children signing up for hellpit programs I have a PT Barnum quote. As do the programs doing the signing.
 
Apropos of a conversation I had today

Ohio has approximately 11 RO graduating residents a year.

Based on 190 residents nationally for 330,000,000 people, Ohio having 11 graduates is quite an oversupply, as that would reflect a state with almost 20 million people (vs OH actually have 11 million people).

MI has a very similar oversupply. How we have 4 residencies and 12 grads a year for a state of 10 million is nuts.
 
On adjacent note, what about recruiting and dinners ?

Some places recruiting is so intense - real estate tours, have to meet every partner, several days, multiple dinners (looking at you Charlotte) and I had fun with that. But, man, for an introvert or people with limited time during interview season what an investment of time.

And, what about the faculty/partners - do you all go to these dinners?

So much of this is personality. I had amazing partners who would never come to the dinners and mediocre ones who loved the free food.

I don't know that the dinner necessarily helps or hurts people (maybe?). I feel like CV and a few conversations during the day seal your fate.
 
RealSimulD said:
Apropos of a conversation I had today

Ohio has approximately 11 RO graduating residents a year.

Based on 190 residents nationally for 330,000,000 people, Ohio having 11 graduates is quite an oversupply, as that would reflect a state with almost 20 million people (vs OH actually have 11 million people).

MI has a very similar oversupply. How we have 4 residencies and 12 grads a year for a state of 10 million is nuts.
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MI and OH… the nation’s rad onc factory!
 
I personally loved it when a post-interview dinner was cancelled, I was worn out from the rest of the day. But then again, that could be the tendency to introvert in me. Or my love of sweatpants.
 
We only go to recruitment dinners for our specialty, so I haven't had to meet any of the several medoncs we've hired over the last few years.

Last radonc in our group locally was recruited 9 years ago, and I definitely would attend any and all events for any radonc recruitment we would have...not that I'm anticipating any in the next several years.
 
RealSimulD said:
Apropos of a conversation I had today

Ohio has approximately 11 RO graduating residents a year.

Based on 190 residents nationally for 330,000,000 people, Ohio having 11 graduates is quite an oversupply, as that would reflect a state with almost 20 million people (vs OH actually have 11 million people).

MI has a very similar oversupply. How we have 4 residencies and 12 grads a year for a state of 10 million is nuts.
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Doesn't Ohio also have something absurd like 10 medical schools?
Speaking of OH and recruitment dinners, I remember when I interviewed for residency at U Cincinnati they did not have an interview dinner, they only had a lunch during the interview day, and it was with other residents in the cafeteria. Even during peak rad onc, that stood out enough that I remember it 10 years later.
 
RealSimulD said:
State itself has <20 million people.

Optimally, would have 11-12 residents graduating per year.

HAHAHAHAHAHAHA

I think that is just two programs.
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What's the total population of all states with no Rad Onc programs?

Odd that you're defining the denominator by the state itself, when it seems jobs are more regional.


Not saying the numbers are appropriate just challenging the metric you came up with of trainees per in-state population
 
CaesarRO said:
What's the total population of all states with no Rad Onc programs?

Odd that you're defining the denominator by the state itself, when it seems jobs are more regional.


Not saying the numbers are appropriate just challenging the metric you came up with of trainees per in-state population
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it's not the best metric - doesn't work at all for the smaller population states.

have a better idea to figure out appropriate number of trainees/programs? Not a challenge - I have no idea how to come up with it!
 
RealSimulD said:
it's not the best metric - doesn't work at all for the smaller population states.

have a better idea to figure out appropriate number of trainees/programs? Not a challenge - I have no idea how to come up with it!
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Other countries/regions do this very well and publish on their methods. UK, Canada, and Netherlands are good examples. When Canada determined they needed to contract training, they had volunteers! Incredible. This was mentioned in the Red J podcast on UK/Canada workforce.

I think this is a lost cause in the US. A rational scientist and/or doctor should look at the totality of the work done over the last few years on this topic and at least recommend a moratorium on expansion and SOAP... ie stay the course and let the market act on itself.

Instead, like so many topics, we have selfish leadership and talking over walking. Maybe Gen Z can save us 🤣
 
NotMattSpraker said:
Maybe Gen Z can save us 🤣
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If ASTRO leadership involves full-time comp and benefits working 20-hour weeks with comfort animals, in house masseuses, ping pong table, free meals, full-sized gym with Olympic swimming pool, and the ability to work 100% remote then maybe they can save us.
 
Gfunk6 said:
If ASTRO leadership involves full-time comp and benefits working 20-hour weeks with comfort animals, in house masseuses, ping pong table, free meals, full-sized gym with Olympic swimming pool, and the ability to work 100% remote then maybe they can save us.
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Is this not how it is now? I assumed this is where the membership fees went...
 
Gfunk6 said:
If ASTRO leadership involves full-time comp and benefits working 20-hour weeks with comfort animals, in house masseuses, ping pong table, free meals, full-sized gym with Olympic swimming pool, and the ability to work 100% remote then maybe they can save us.
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No in house coffee shop, avocado toast? No thank you sir, I’ll go back to living in my parent’s basement! You are cancelled!!
 
Neuronix said:
I wonder if he would have posted that when he was a resident at Sloan or if he was chair at any PPS exempt center. Easy to throw stones now from outside the glass house, isn't it?
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Residents at Memorial may feel that way but are under understandable pressure (whether internal or external) to not throw shade on their own training program where they can be penalized. Most faculty probably feel similarly about publicly critiquing their own programs.

Does it really matter he trained there (except for maybe making him more aware of the unfairness of PPS exemption)? It isn't necessarily a bad thing to use a speaker once you are empowered to use it. Even if he were the chair of a PPS exempt center, he could advocate for this (quite hypocritically) knowing that statements like that on twitter mean nothing while outwardly supporting 'equity' while keeping the massive bills rolling.
 
Neuronix said:
I wonder if he would have posted that when he was a resident at Sloan or if he was chair at any PPS exempt center. Easy to throw stones now from outside the glass house, isn't it?
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Pps exemption is unfair but it misses the point. Upenn is not pps exempt, but I am sure they crush most pps exempt centers when it comes to negotiated prices. cwr may also charge extreme prices in their market?
 
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medgator said:
@Dan Spratt ?? Pretty ballsy to be expanding a second fiddle program in a Midwest Metro imo
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Come on SDN! I said we are not expanding and we haven’t. We still have 7 spots before I got here and still now despite us having 35% higher clinical volume and 6 incremental faculty. For whatever reason UH is 3 one year, 2 one year, and then 1 a year the other years.

Have a little faith. No need to put our program on the firing squad. Working our tails off to make it an amazing training program and also not contribute to the problem.

We have hired 5 extra RN partners and 4 additional APPs to keep attendings well supported and not rely on residents for pure clinical coverage in order to prioritize their education. Majority of faculty go uncovered as we have I think one of the highest faculty to resident ratios in the country now. Residents get exposure to almost everything too (unlike a lot of training programs) with brachy, Gammaknife, IORT, protons, MR linac almost live at our VA, brain brachy with gamma tile, etc.

Just wanted to set the record straight as we are trying to do something very special at UH and have blown up the hierarchal academic model and tried to support great training without expansion, great salaries (75th percentile) while working with a team and positive culture, and insure incentives align with values and not just wRVUs or papers that are done just to get a CV line.

Best
Dan
 
RickyScott said:
Didn’t they fill exclusively last year from the carribean?
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Heck no man. My first year here we were fortune to match one of our most favorite rotators and she is amazing. Hoping for another great match this year. I can’t comment on the past but I see your concern that you thought our program expanded (incorrect) and were solely going through SOAP (incorrect). That would be a problem if true. We have not expanded, but have revamped our program as making it an amazing place to train and raising our game will be the way to ensure we match.

Feel free just to email me if you have questions about our program.
 
Dan Spratt said:
Come on SDN! I said we are not expanding and we haven’t. We still have 7 spots before I got here and still now despite us having 35% higher clinical volume and 6 incremental faculty. For whatever reason UH is 3 one year, 2 one year, and then 1 a year the other years.

Have a little faith. No need to put our program on the firing squad. Working our tails off to make it an amazing training program and also not contribute to the problem.

We have hired 5 extra RN partners and 4 additional APPs to keep attendings well supported and not rely on residents for pure clinical coverage in order to prioritize their education. Majority of faculty go uncovered as we have I think one of the highest faculty to resident ratios in the country now. Residents get exposure to almost everything too (unlike a lot of training programs) with brachy, Gammaknife, IORT, protons, MR linac almost live at our VA, brain brachy with gamma tile, etc.

Just wanted to set the record straight as we are trying to do something very special at UH and have blown up the hierarchal academic model and tried to support great training without expansion, great salaries (75th percentile) while working with a team and positive culture, and insure incentives align with values and not just wRVUs or papers that are done just to get a CV line.

Best
Dan
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Got it. What is to stop you from holding one of those spots out of the match year given clear workforce concerns until the results of the ASTRO workforce study are available? 7 is an odd number anyways for a smaller program. Just do 2-2-1-1 as your 7th spot was only recently approved in 2019 was it not?

Anderson and your big brother in Cleveland have done just that and actually and reduced a spot they are offered in the match
 
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