elementaryschooleconomics

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I didn't know what an iso was for 6 months. Everyone kept saying it so I knew it was common knowledge and I didn't want to look stupid by asking.

Oh my God, I think I have about 4,000 stories like this.

For lurking medical students and residents, if these posts resonate with you, I HIGHLY recommend this book:

1605289744010.png

I have searched high and low for something that answers fundamental questions that everyone seems to know but you're too afraid to ask, and I think this is one of the best that's out there right now.
 
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Oct 27, 2013
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My program director told us stories of a resident who didn't once see a linac throughout his residency... Deep down I know this is very possible at some programs.

Certainly need to change the paradigm of memorizing every study under the sun, but can't handle some radiation dermatitis or set up a patient on a linac.
 

scarbrtj

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My program director told us stories of a resident who didn't once see a linac throughout his residency... Deep down I know this is very possible at some programs.
Certainly need to change the paradigm of memorizing every study under the sun, but can't handle some radiation dermatitis or set up a patient on a linac.
In the "old days" you had to know how to hand calc to get some MUs, put a patient on the table, take a 1 MU port film, and mode the machine up for your 3 Gy or 500 rad PA spine fraction (no one did 8 Gy!) or whatever. So that in theory you (resident MD) could do all that yourself if need be. Ideally would be one of the first things to teach a resident IMHO. Very simple RT: What are we doing? How do we do it? Why do we do it?
 

elementaryschooleconomics

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My program director told us stories of a resident who didn't once see a linac throughout his residency... Deep down I know this is very possible at some programs.

Certainly need to change the paradigm of memorizing every study under the sun, but can't handle some radiation dermatitis or set up a patient on a linac.

Yup, I was told about a person who showed up to oral boards and didn't know what a VacLock was.

When I first heard that, I just couldn't believe it, how is that possible? How can you complete residency and be eligible for oral boards with that gap in knowledge?

Subsequently, I have observed enough about this field to think...yeah...yeah that's definitely something that could happen.
 
Apr 21, 2011
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Vac-Lok is a trademarked brand name from Civco. Though it is used rather ubiquitously in the field like "Kleenex". I suppose it's possible that they use another brand or even a foam based system like AlphaCradle and had just never heard the term.
 
Sep 22, 2016
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Vac-Lok is a trademarked brand name from Civco. Though it is used rather ubiquitously in the field like "Kleenex". I suppose it's possible that they use another brand or even a foam based system like AlphaCradle and had just never heard the term.
I remember having to look up AlphaCradle and realizing it was another immobilization like Vac-Lok. For the longest time I thought it was something to make prostate patients comfortable while also feeling extra manly.
 
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In the "old days" you had to know how to hand calc to get some MUs, put a patient on the table, take a 1 MU port film, and mode the machine up for your 3 Gy or 500 rad PA spine fraction (no one did 8 Gy!) or whatever. So that in theory you (resident MD) could do all that yourself if need be. Ideally would be one of the first things to teach a resident IMHO. Very simple RT: What are we doing? How do we do it? Why do we do it?

Valid point but can't help but think about the older attendings that wax poetic about wax pencils and port films, and how hard residency used to be...when there was one trial to know and one dose of radiation to give.
 
Apr 21, 2011
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Valid point but can't help but think about the older attendings that wax poetic about wax pencils and port films, and how hard residency used to be...when there was one trial to know and one dose of radiation to give.
Head and neck plan? Swoosh, swoosh, larynx block at match, swoosh, posterior electrons, swoosh, done. 2 minutes.
 
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Gfunk6

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My biggest screw up was also during my first year of residency. I had a very nice and supportive attending and we were treating a post-op extremity sarcoma patient. The attending told me to take a crack at the contours first and that he would review and modify on the back end.

I researched the topic extensively and took my time to meticulously draw contours as well as (probably unnecessary) OARs. Obviously I wanted to impress.

I proudly called over my attending and asked that he review. He glanced at it, smiled at me and said, "Gfunk6, you contoured the wrong leg."

The patient was simulated feet first! Jesus I've never lived that one down - I was still hearing that story during my PGY-5 year. :)
 

Radonc90

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elementaryschooleconomics said:
...Ralph with another drive-by douchebag Tweet...RadICaL cAnDOr

The resident seems like a nice guy. Not sure why RW said something like it.
Maybe RW is jealous bc the resident can do HN brachy with appropriate attending.

Now, I am telling you, I am not following RW's twitter for a reason, very few tweets from RW that are worthwhile to read.
 
Jan 26, 2013
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This is bullying by RW plain and simple. His ignorance of whether this was a resident is a not an excuse. Mean, harmful behavior is mean and harmful regardless.

is there a professionalism office at UC that we can anonymously complain to?

Good example of where our field is at. Big names publically harass residents. While at the same time well intentioned and well reasoned docs are forced to express themselves on an anonymous forum because they are delisted or cancelled on platforms such as ROHub or Twitter.

Med students, this is indicative of the state of this field. Not even to mention the job crisis. The two are not unrelated.

I encourage us all to identify professionalism resources (Including any twitter handles for tagging purposes, such as those of relevant provosts and deans) at relevant universities. This is a lever of influence that has not yet been pulled: reporting such behavior to influencers outside the insular RadOnc world.
 
Nov 18, 2020
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There are several inaccurate posts here..

1. University of Kentucky's pension data quoted above is outdated. UKY hasn't been offering any pension plan for any of it's employees for more than a decade. But UKY's retirement 403b matching is excellent and probably one of the best in academia.

2. As Radoncpotamus said, starting salary is not 240K, its upwards of 320K and as Neuronix said, Its comparable or slight better than other academic offers in midwest region(One of my co-resident was offered $300K from Ohio state). UKY hired two new facutly who will start in August of this year. And salary/bonus increases with performance in the first 5 years.

3. Dr. Randall is an amazing chair, excellent educator and strong resident advocate. He is always ready to pick up phone and bat/vouch for most of his residents and helps open opportunities that otherwise would not have been available. He makes as many calls as resident asks and completely on resident's side during stressful Job search process. He also helps resident evaluate different Job offers (both academic and private practice) and advice in the right direction. He is a chair every resident would want to train under.

4. In the last 10 years most of his residents had Job offers by PGY-4 itself. One resident (superstar) signed in PGY-2 and another resident (another superstar) signed in the end of PGY-3. Current chief has more than one Job offer in her PGY-4 itself in the region of her choice..

5. Dr. Randall is also very good mentor for early career faculty. He helped newly hired faculty to get onto NRG committees and become PI on national protocols which is what most of early career faculty wants.

6. More importantly Dr. Randall is an awesome educator and pioneer in Cs-131 brachytherapy in recurrent gynecological cancers. He had patients coming in from California, NJ and Texas all the way to Kentucky for these procedures. He encourages autonomy while doing brachytherapy cases. Most of the residents logged >200 brachytherapy procedures (Gyn and Prostate) towards the end of the training.

People will lose allies by making personal comments (financial earnings) and using derogatory language. It is very reasonable to ask for data. Scarbtj posted a nice mathematical analysis on SDN about how many new consults each Rad Onc needs annually to have a rewarding/financially stable career. I thing that analysis should be submitted to Journals for publication. Then people will find more allies for their cause..
Oh my, I just read all the comments regarding UK and Dr. Randall! Thank you for posting this defense. All I can say is that I am happy that I didn't read these comments prior to taking my job, which is currently at UK.... Dr. Randall has been great and Lexington is an absolutely beautiful town.

It's easy for people to hide behind anonymous names and spread negativity about our field, especially when one is not satisfied with their own situation. If one really cares, perhaps they can work hard to come up with solutions to the problems we are currently facing.

Take Care.
 

OTN

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Oh my, I just read all the comments regarding UK and Dr. Randall! Thank you for posting this defense. All I can say is that I am happy that I didn't read these comments prior to taking my job, which is currently at UK.... Dr. Randall has been great and Lexington is an absolutely beautiful town.

It's easy for people to hide behind anonymous names and spread negativity about our field, especially when one is not satisfied with their own situation. If one really cares, perhaps they can work hard to come up with solutions to the problems we are currently facing.

Take Care.

While it may be "easy for people to hide behind anonymous names...", as the great Dr. Simul Parikh, MD recently found out, it's literally impossible to use your actual name to try to affect change.
 
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Being at UK for a few months and being happy does not mean “randall is great”. On a personal coversational level i am sure he is ok. He had a chance to lead and he chose to say “where is the data”? He told people who he was and what he stood for, as a “leader”.

Not surprisingly, UK is once again in the market for warm bodies this application cycle, applicants highly beware, as faculty are incentivized to lie to you to maintain coverage at their very low tier program. New faculty are incentivized to talk up the place, understandably. You have a choice. Look elsewhere if you can.
 

medgator

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Oh my, I just read all the comments regarding UK and Dr. Randall! Thank you for posting this defense. All I can say is that I am happy that I didn't read these comments prior to taking my job, which is currently at UK.... Dr. Randall has been great and Lexington is an absolutely beautiful town.

It's easy for people to hide behind anonymous names and spread negativity about our field, especially when one is not satisfied with their own situation. If one really cares, perhaps they can work hard to come up with solutions to the problems we are currently facing.

Take Care.
Sorry but Dr Randall is absolutely clueless regarding the job market in rad Onc and it showed with his inaccurate posts on ROHub earlier this year.

Kentucky has probably had a decent job market and will probably continue to do so. Kentucky isn't Texas, Florida, NC or California though
 

fiji128

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I’ve heard some unsavory stuff about Randall from people who have worked for him. Just have to do some sniffing around. Trick is to know your place and do as your told from what I understand. My impression is he is your classic boomer bully chair when it comes down to it. His public RO Hub comments kinda hint at that.
 
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fiji128

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If one really cares, perhaps they can work hard to come up with solutions to the problems we are currently facing.
A great “what can I do solution” for the field would be to be a strong advocate for UK going from 6 residents to 4. They currently only have 4 clinically active faculty according to their website for 6 approved residency positions. What’s with that?
 
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I’ve heard some unsavory stuff about Randall from people who have worked for him. Just have to do some sniffing around. Trick is to know your place and do as your told from what I understand. My impression is he is your classic boomer bully chair when it comes down to it. His public RO Hub comments kinda hint at that.
Biblical plantation “know thy place” is how old white men boomer chairs like their workers
 
Oct 4, 2017
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Oh my, I just read all the comments regarding UK and Dr. Randall! Thank you for posting this defense. All I can say is that I am happy that I didn't read these comments prior to taking my job, which is currently at UK.... Dr. Randall has been great and Lexington is an absolutely beautiful town.

It's easy for people to hide behind anonymous names and spread negativity about our field, especially when one is not satisfied with their own situation. If one really cares, perhaps they can work hard to come up with solutions to the problems we are currently facing.

Take Care.
Given the top 25-30 programs can accommodate all us mds, would you suggest that medstudents forego a reputable training program for bottom tier Kentucky in this job market?
 
May 30, 2019
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New faculty are incentivized to talk up the place, understandably.

This is quite likely the most damning part. A brand new faculty does not make an account to post a single reply to a months old post of his or her own volition. This was something that senior leaders at UKentucky told them to do. More lies and gaslighting from people who cannot accept their own role in getting our specialty into the current situation.
 

elementaryschooleconomics

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1605803494863.png

This is RIDICULOUS.

In the past, the OnDemand access was available to anyone who paid the full registration price for the ASTRO meeting. I loved that feature, because there's just too much stuff to get to in a short amount of time, and I would periodically go back to things if manuscripts weren't out yet or if there was a particular clinical scenario which I needed to research more, etc.

So this year, NOT ONLY did we pay full price for the virtual meeting...we don't get continued access?!?! I have to pay MORE money for this?

Man, ASTRO...you guys really want that cash. Dollar dollar bill y'all! We'll reduce those fractions but we ain't gonna reduce them FRANKLINS.
 
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medgator

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I didn't pay for the Annual ASTRO Zoom meeting, can I get the meeting on demand for $150 too? :)
That would be consistent with 1) spiting the collective membership that did pay up for the virtual meeting and 2) maximizing revenue as much as possible. Therefore i can't imagine it wouldn't be allowed
 
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The virtual “auditorium” listed how many people were present. You could also go to the lounge and see how many people chatting.

I registered and attended. There were never more than 2000 attendees listed in the auditorium, and the chat lounge was mostly reps.

In contrast, recent in-person meetings have had about 10,000 attendees. ASTRO has to make up that income to pay for all those salaries somewhere... why not $150 at a time?
 

OTN

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I don't recall Mayo Clinic ever taking much interest FMG applicants or even non super star US MD applicants before. Wonder what brought on the change of heart?

Do what they say, not what they do. YOUR program needs to take these (incredibly compassionate, full of integrity, bursting with character the rest of us could only dream of having) FMGs, board scores be damned. Mayo does not.

YOUR practice needs to worry excessively about the financial toxicity of your patients. Mayo does not.

I would say the hypocrisy is stunning, but it's just business as usual.
 
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It’d be really great if the compassion for incoming applicants with theoretical lower board scores or other countries (whose presumed increased applications are tied more to higher chance of success in obtaining US visa sponsorship, which is a regular part of the system, rather than organic interest in cancer or cancer patients.... otherwise they could have applied in previous cycles) extended to the grads with outstanding dedication to the field and oncology as shown through the differences in metrics used on residency and job applications.

Otherwise kinda feels like a kabuki theatre approach to keep the pipeline for note writing bodies through the doors.
 
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RadOncMegatron

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Do what they say, not what they do. YOUR program needs to take these (incredibly compassionate, full of integrity, bursting with character the rest of us could only dream of having) FMGs, board scores be damned. Mayo does not.

YOUR practice needs to worry excessively about the financial toxicity of your patients. Mayo does not.

I would say the hypocrisy is stunning, but it's just business as usual.


It is really something to watch the elite schools based on meritocracy come out and start advocating "board scores aren't everything" kind of approach. We ALL know as physicians, the grades / scores / CV game and have suffered much from it all since basically grade school. Now for these guys (and gals!) to come out and be like "Yo, you low and mid tiers take the FMGs and DOs b/c you know us at Mayo cannot dirty our hands with someone with a low board score (ok maybe just one but they had 5 JCO pubs). We are an elite program we cannot take such people! But you state school residency program, you should be fine with whoever comes through your door." Who do they think they are fooling?

On a side note, I wonder what will happen after there step 1 is pass / fail. The only thing I'm sure of is that, the name brand programs, will cont. to get the best and brightest, it just won't be based on step 1...
 
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These hellpit places which routinely fill with warm bodies will eventually suffer and hopefully collapse under the weight of their own incompetence, poor planning, inability to function without competent residents who “can teach themselves”. I look forward to watching the fireworks! (Insert that Dicaprio Gatsby drink meme)
 

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