Mudit is pretty good if you're not following already across what seems like all major conferences (ASTRO/ESTRO/ASCO). There are definitely others but he's the one that sticks out the most.
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drewdog1973
Full Member
So glad we have such great attendings teaching the residents of #radonc.
😂 😂
I usually just draw a big 10 cm circle and hope for the best.
I presume most people here have had a mask made on em. Based on that, ive never even considered asking the patient to be sure and look straight. Because who the **** wouldn't do that in the first place?
Strikes my as absurd, but who knows. I guess our therapists just suck. Will defer to scar. Maybe these guys can also give us pointers on calibration of monitors for contouring. I am sure that also makes all the difference in the world.
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biggest source of error is fusion. I am still not convinced that most of us can tell if fusion is globally off by 1 mmm, which matters when treating multiple lesions with one iso.
MRI gives you nystagmus ("We found that all healthy human subjects lying in the static magnetic field of an MRI machine develop a robust nystagmus."). So figure that in w/ fusion. If you do, you're smarter than I.
And I guess this guy (congenital robust physiologic nystagmus) just will never be a radiosurgery candidate... in some certain abstract instances.
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Man I wish I had found this paper when it was published. Have you ever been near the research MRIs that are at least 7T? They make me feel...off, and all the bench scientists I say this to look at me like I'm crazy (and somehow never find time to experience it themselves).
Congenital robust nystagmus, no. Acquired lethargic nystagmus, yes.
WHO'S CRAZY NOW (probably still me)
Given his extreme focus on CNS Rad Onc during his residency (and to clarify, he is currently a PGY-5 despite his profile and what he represents himself as a CNS 'expert' across multiple forums), I am going to laugh if he ends up in a generalist job somewhere....
Word is he secured a good academic CNS position. It's not my style to post like he does (or most of the Twitter self-promotion echochamber), but on balance it's good to have some proportion of people in the field do that. Wouldn't wish anything bad on him and happy that he's making it work.
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Hmm interesting...yeah, he did have a Tweet that he had signed an academic job but it appears he deleted it? Not sure why so I won't blow up his business here.
Agreed. But need more Spratt's. Don't need to hear how I don't know to tell my patients to refrain from doing a kit-cat clock impression during SRS.
He has an interest in CNS which is obvious and I expect that he will be an aggressive advocate for the specialty and his patients as a CNS attending. I am glad that he has achieved an attending position in-line with his knowledge base and his interests.
While he still rubs me the wrong way occasionally, so did Dan Spratt as recently as 2 years ago, whose twitter I now significantly appreciate.. It's just the whole "I'm a resident who doesn't state that he is a resident and gives answers like a CNS expert who has been an attending for > 10 years would answer". My opinion of him will probably evolve in the next few years once he actually is a dedicated CNS attending.
Fake it till you make it
My understanding is that his PhD work was relevant to the validation/marketing of RapidArc.
Hell, he may cure GBM’s... until then his job is to “shut up and dictate notes!”
I’m kidding, residents also need to contour and get medical records faxed!
I’m kidding, residents also need to contour and get medical records faxed!
Tweet also rubs me wrong way. Recognize some trivial source of error and are implying superiority/holier than thou in their process over others: phrase “good therapists know to ...” is catty to say the least. high quality stereo can be delivered without instructing pts to stare straight ahead. (In fact as others pointed out, it is quite difficult for pt to do anything other than state straight ahead for 15 minutes.)
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Perhaps a trial on periorbital srs, where you have the patient look "towards" the lesion to pull the ON away.
Said here first, folks.
At least it wouldn't smell like an ER, it'd smell like an A&F. Wait...
At this rate, radiation oncology residents graduating will all be applying to A&F soon. Hopefully, by then the pandemic will be over with.
I'm more of a Hollister resident myself.
I completely agree with her. Too many doctors have never had real jobs, let alone service jobs where people treat you like crap, and if you don’t show up on time you’re fired. Heck, you can be fired for literally anything. I suspect some of the “I studied hard for years so I deserve the job of my dreams” entitlement comes from this lack of real-world experience.
I don’t know many people who never had a “real job” prior, during or even after attending medical school. I had about 3 jobs and although fulfilling, nothing came harder to me than to receive my medical education.
I believe if a person works hard enough to get through medical school and residency, yes they deserve to have their “dream job” as does anyone else who has ever followed his or her dreams and committed their livelihood in order to reach that goal.
I've never seen a career outside of medicine that makes you wait so long for a full salary position. I've also never personally seen a career with such poor job opportunities and large non-competes.
I was never attractive enough to work at Abercrombie and Fitch. I worked several jobs in IT, research labs, and a summer at the post office before med school. I have a lot of friends still in tech. My male family is all either in construction or truck driving.
Here's the difference: they jump around jobs in their area all the time. Boss pisses you off? See ya. New job paying 20% more down the street? Bye. Most of them have also been making 6 figures since their 20s if they want to work for it with no educational debt.
There's no way my family members could do this job both due to the education and stresses involved. I'm the only one in my family to attend college, most of my family are high school dropouts, and my dad couldn't read when I was growing up. I will tell you this: they wouldn't put up with some of the **** I've had to put up with.
I was never attractive enough to work at Abercrombie and Fitch. I worked several jobs in IT, research labs, and a summer at the post office before med school. I have a lot of friends still in tech. My male family is all either in construction or truck driving.
Here's the difference: they jump around jobs in their area all the time. Boss pisses you off? See ya. New job paying 20% more down the street? Bye. Most of them have also been making 6 figures since their 20s if they want to work for it with no educational debt.
There's no way my family members could do this job both due to the education and stresses involved. I'm the only one in my family to attend college, most of my family are high school dropouts, and my dad couldn't read when I was growing up. I will tell you this: they wouldn't put up with some of the **** I've had to put up with.
This is what it's like for me talking to a few close family members as well. I'll call my Dad, who's getting a pension from his first career and now working trades - "eh the contractor managing that site was a d**k, I didn't feel like dealing with him anymore, so I just left. I found a new site the next day though that pays me a lot more per hour though, hahahaha"
Me: "Oh yeah I totally relate, one of my bosses spent a chunk of time informing me I was worthless yesterday, and I thanked him for the learning experience, hahahaha"
Yup, why I post. Only field in medicine I know if where if you lost you job, may not find another, and would likely have to move across the country.
Everyone should have to work a minimum wage job in the service industry for at least 12 months. We'd probably all treat each other a little better and appreciate what we have a little more.
It’s called a rad onc fellowship!
Nah... I know we like to joke about things like this, but when you're getting screamed at by an executive chef for not scrubbing a pot clean enough even though your hands are bleeding from the detergent and steel wool while making $5.15/hr for the privilege, you can stomach most anything. People need to learn to respect the grind.
Working a regular crappy job prior to medical school and then wanting a good (or any) job after enduring medical school and residency are not mutually exclusive.
I agree that every medical student should have some real world customer service work experience. There are plenty of med students that have never had real jobs before - they've never had to. IMO, people that have dealt with the service industry in some aspect are better prepared to handle the variety of patient/staff/physician interactions and are more grounded.
I agree that every medical student should have some real world customer service work experience. There are plenty of med students that have never had real jobs before - they've never had to. IMO, people that have dealt with the service industry in some aspect are better prepared to handle the variety of patient/staff/physician interactions and are more grounded.
I know what you're saying. I'm gonna be real frustrated if I don't get my last paycheck before the end of the year, when I go into the 35% bracket.
I’m telling you that’s a rad onc fellowship!
I’m kidding, I agree, def appreciate the job I have and quality of life I’m able to live but it definitely didn’t come without hard work and sacrifice. I think it was the statement that we are somehow “entitled” because we expect to have a “good job” was an insult to the struggle. I’m not going to judge one profession over another but if you work hard in life, you should expect to be rewarded... that’s what Rocky would say!
"Job of my dreams" in radonc often implies a desire to practice near family/ hometown. That is not entitlement.
Right, “job of my dreams” is being the owner of a professional sports team or playing video games for a living. One could even say that the “job of my dreams” is to not have a job but a billion dollars in the bank account. Right now I just want to live in a city where I can eat biryani and not be homeless.
This why representation and diversity matters. I went to school with a large amount of country club crowd. Many of my classmates were legacy and or came from a multigenerational family of high earners (doctors, lawyers, etc). Not surprisingly many of these people had never had a real job in their life. Over the past ten years many of these people then went into rad onc for a nice life. We should not be surprised with what many perceive to be an issue with medical school graduates.
He previously announced he accepted a position at Ohio State where I imagine he's going to focus on CNS. He's also MD/PhD and did a lot of work pre-residency with Varian on linac based SRS, which may be why he's so focused on CNS. I have no idea how he is clinically or with other disease sites, but I think it's that PhD work in SRS that makes him feel entitled to enter the fray at an "attending" level on those issues.
Pretty sure he's referring to this (which made the twitter rounds earlier this year). Even under the masks or with closed eyes, patients could shift their "gaze" left or right and that could move the optic nerves.
I do feel like there is a sense of entitlement in radiation oncology, but how can you blame us? Say you are in medical school in mid 2000s, early 2010s trying to decide what you want to do in life, and you see that rad oncs do cool things and are living the good life. You work towards your goal of becoming a rad onc, you get into residency, then when you get out, the field is on this downward spiral. No other field, to my knowledge, has expanded as rapidly while simultaneously seen a decrease in utilization and reimbursement creating such a tight job market. This is not what we signed up for. Yes, we make decent money, even by physician standards, but the ceiling is lower than it was and your job options are much more limited than when we applied to rad onc. Residents from the last decade have gotten to ole' switcharoo. Had I known rad onc was going to change that much in the 5 years I was in residency, I would have likely applied to something else. Residents prior to that probably at least got a taste of the golden age of rad onc and now watching it sink. Upcoming residents know exactly what they're signing up for, so don't want to hear anything from them when they graduate...
Despite my saltiness over the direction of rad onc, I am grateful to be making what I make working 40-45 hours week. Still seems a little bit surreal as a 2nd year attending. I just need to remember the time I worked as a research assistant for minimum wage after getting my BS in biochem - that was some bull****, lol.
What’s wrong with “those people” wanting to go into radonc for a nice life?
When the need arises for the field to consider expanding spectrum, being more involved with inpatient things, taking more ownership of medical issues, thinking outside box to start systemic therapy training, these are the same people who see no need for this because they value lifestyle over being oncologists
This would be a great topic to discuss on radonc rumors @elementaryschooleconomics
I need to get Garage Band on my phone to make the intro music.
I'm sure the obnoxious boomer persona chair stereotype didn't help either with new Moffitt leadership coming on board.
Word on the street is that he stepping down to spend more time with his family (didn't want to get too creative with the excuses).
my understanding from inside sources is COVID has made him re-evaluate priorities and he wants to spend more time with family. - nothing to do with China
drewdog1973
Full Member
China has everything to do with Covid, my friend. Everything.
