Rad Onc Twitter

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radonc17 said:
At this point I feel those “leaders” who think nothing is wrong need to PROVE it more than we do

In 5 yrs, if they are right then no harm done to individuals or society as there is not a “total under supply in US”

In 5 yrs, if they are wrong then graduates will be left in financial disaster. Those same leaders aren’t going to dip into their personal finances to help them

I tried to emphasize on Twitter yesterday, hopefully someone will see sense
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Ah, the Pascal's wager that the scarb used to refer to...

sxnvecU.png

...the logic of which escapes rad onc's greatest minds it seems.
 
Simul Parikh should have the ASTRO, RRC, ADROP, SCAROP leadership commit to immediate and drastic action, contingent on the independent consultant's findings, prior to starting the investigation.

You know, academics like to sit on research findings, or delay implementation with meetings, committees, antitrust BS, and other nonsense. The Valley of Death. If the consultant says America has enough BC radiation oncologists for the next 15 years, then residency programs should stop participating in the NRMP Match for the next 10 years.

Without such an ex ante commitment prior to the investigation, some amongst the radiation oncology leadership will be tempted to stall, delay, dismiss, disparage, and discredit, if the consultant's findings do not support the status quo.
 
yesmaster said:
Simul Parikh should have the ASTRO, RRC, ADROP, SCAROP leadership commit to immediate and drastic action, contingent on the independent consultant's findings, prior to starting the investigation.

You know, academics like to sit on research findings, or delay implementation with meetings, committees, antitrust BS, and other nonsense. The Valley of Death. If the consultant says America has enough BC radiation oncologists for the next 15 years, then residency programs should stop participating in the NRMP Match for the next 10 years.

Without such an ex ante commitment prior to the investigation, some amongst the radiation oncology leadership will be tempted to stall, delay, dismiss, disparage, and discredit, if the consultant's findings do not support the status quo.
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That's a lot of pressure on 1 person!

Given that many within these parties have been reluctant to change, I doubt this April 1st VVPN will lead to meaningful change

I fully expect it to circle the same discussion and arguments we have had on here and on twitter.

The only positive is that at least ppl are openly speaking up now
 
What about "ASTRO accredited" residencies? Make standards high.

This wouldn't dictate whether a place is allowed to open a residency, just how that residency is viewed by the community.
 
Lamount said:
What about "ASTRO accredited" residencies? Make standards high.

This wouldn't dictate whether a place is allowed to open a residency, just how that residency is viewed by the community.
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Are we really going to give them more money??

I still don't understand the purpose of ASTRO APEX accreditation

Legitimate question, do patients actually come to your institution specifically for that?
 
radonc17 said:
Are we really going to give them more money??

I still don't understand the purpose of ASTRO APEX accreditation

Legitimate question, do patients actually come to your institution specifically for that?
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Nope. It’s all about trying to gain an edge on the competition somehow.

Best thing to do is to bribe referring docs.
 
Lamount said:
What about "ASTRO accredited" residencies? Make standards high.

This wouldn't dictate whether a place is allowed to open a residency, just how that residency is viewed by the community.
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I'd preferentially support an SDN accredited residency at this point.
 
In May 2020, Smith sent that tweet.
In Dec. 2020 Dec. 2010, Smith et al (incl Rutgers and Yale etc.) published the JCO article as mentioned above.
(Date Corrected).

I will put both of these screenshots together for everyone to see.

PS: As mentioned before, I strongly believe we need only 80-100 PGY-5's per year...

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Radonc90 said:
In May 2020, Smith sent that tweet.
In Dec. 2020 Dec. 2010, Smith et al (incl Rutgers and Yale etc.) published the JCO article as mentioned above.
(Date Corrected).

I will put both of these screenshots together for everyone to see.

PS: As mentioned before, I strongly believe we need only 80-100 PGY-5's per year...

---
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I think that paper is the original 2010 paper, despite the JCO date in your screenshot...don't know why it's displaying like that.

1616095245161.png
 
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Derm seems to have no problem being highly competitive and attracting a large proportion of women, I’m not sure that the back handed misogynistic silver lining of “now that we’re less competitive we can be more inclusive” holds much weight.

People in power recruit those that they connect with, I.e. people who look and act like them. People being recruited gravitate to places that they fit in, I.e. places that match their demographic.

As someone whose made the unfortunate mistake of bringing his wife to an ASTRO event, I can attest that there’s no bigger turnoff to a woman than being hit on by a bunch of drooly mouth breathers. It’s a bit of a self fulfilling prophecy but I’d imagine when many underrepresented potential Med students consider radonc and see a bunch of old white men who stare at them like they’re some newly discovered Inca tribe, they think “hmm, this probably isn’t the place for me.”
 
RSAOaky said:
Derm seems to have no problem being highly competitive and attracting a large proportion of women, I’m not sure that the back handed misogynistic silver lining of “now that we’re less competitive we can be more inclusive” holds much weight.

People in power recruit those that they connect with, I.e. people who look and act like them. People being recruited gravitate to places that they fit in, I.e. places that match their demographic.

As someone whose made the unfortunate mistake of bringing his wife to an ASTRO event, I can attest that there’s no bigger turnoff to a woman than being hit on by a bunch of drooly mouth breathers. It’s a bit of a self fulfilling prophecy but I’d imagine when many underrepresented potential Med students consider radonc and see a bunch of old white men who stare at them like they’re some newly discovered Inca tribe, they think “hmm, this probably isn’t the place for me.”
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some of these chairs get so thirsty after a few drinks. Glad your wife made it out ok. Hide your kids, hide your wife!!
 
Radonc90 said:
In May 2020, Smith sent that tweet.
In Dec. 2020 Dec. 2010, Smith et al (incl Rutgers and Yale etc.) published the JCO article as mentioned above.
(Date Corrected).

I will put both of these screenshots together for everyone to see.

PS: As mentioned before, I strongly believe we need only 80-100 PGY-5's per year...

---
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In 1995, the U.S. was producing ~150 residents (plus 30-40 fellows) per year. (By around 2000 this had been corrected to closer to 100 residents per year.) At what I think was the zenith of unemployment pain and worry in that day:

- 7% of RO grads were unemployed <6 mos after graduation; 4% longer than that
- 11% were underemployed <6 mos after graduation; 12% longer than that

For reference, there was 1 RO per 100K population in 1995, and cancer incidences were almost the same then as now (about 440 per 100K). Now, we have almost 70% more ROs per 100K... 1.7 ROs per 100K. That's going to be about 1.8 ROs per 100K in 5 years.
 
Neuronix said:
Guys you are welcome to name and shame the programs. Student doctor network is about helping students to become doctors. Making fun of individual residents is not allowed.
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thank you @Neuronix

I highly value many SDN opinions, but naming individual students only makes the fight against oversupply even tougher

It’s the people at the top who have let us down not the individual students
 
Agree with @Neuronix,

- A few bad apples do not define SDN crowd. I believe most people here are great.

- These M4's: we need to congratulate them for their accomplishments. They are our colleagues.
The oversupply was not created by them, it was created by our fearsome leaders...
We may not remember this: but 4 yrs of med school was challenging, passing Step 1/2 was also challenging, interviews were "scary". Then 5-6 years of hard work, sometimes abused by the attendings...
Again, we need to encourage them...
The road ahead will be challenging, but I hope things work out for them 5-6 yrs from now.

- There has been focus on this field on the "toys" (MRI Linacs, fancy this and that), which I am not against, but we need to get down to the basic stuff. If a program that can graduate a resident that can take care of 95% of routine stuff properly, and refer the tough 5% to high-volume centers, then that program is great.

- Just look at gensurg, how many gen surgeons in the community can handle a Whipple properly? I can tell you it is close to zero, I have seen a lot of half-ass Whipple from the community (poor pts!). Data clearly shows survival is better at high-volume centers. This is a very difficult procedure, even for the seasoned surgeons. The key thing I have learned from the expert surgeons: fix the stuff, then send the pt back to the community MDs for further care, don't hang on to the pts, it will create animosity with the referring docs.
So, when a radonc refers me a tough case, I fix it and send the pt back.

PS: During "my time", we matched, worked hard and moved on.
None of these tweets and publicity.

Anyway, since Twitter already makes noise, I might as well...lol.
We need to congratulate the M4's.
There is one that came across today on my Twitter feed that stood out from the rest. She worked hard and matched, and I am really glad for her. I think she will do well. They struggle very hard to get to this point...So, congrats!!!

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I posted to show that emory soapd their three spots which is a failure of the program. I agree with not posting individual names.


EDIT - I am being told emory had 5 spots, matched 2, filled 2 more in soap, and left one unfilled.
 
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evilbooyaa said:
I posted to show that emory soapd their three spots which is a failure of the program.
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Is there a document showing who soap’d and how many spots? 3 SOAP spots?!? Utterly shameful by Emory and truly disgusting. How can they do something so rotten?
 
deleted post removed
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My attention has been a bit divided by a complicated pregnancy and my son's birth last night. Please forgive me for being slow on the trigger to remove toxicity. Please report objectionable stuff, then other mods can alert me or remove it themselves.
 
Radonc90 said:
- Just look at gensurg, how many gen surgeons in the community can handle a Whipple properly? I can tell you it is close to zero, I have seen a lot of half-ass Whipple from the community (poor pts!). Data clearly shows survival is better at high-volume centers. This is a very difficult procedure, even for the seasoned surgeons. The key thing I have learned from the expert surgeons: fix the stuff, then send the pt back to the community MDs for further care, don't hang on to the pts, it will create animosity with the referring docs.
So, when a radonc refers me a tough case, I fix it and send the pt back.
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Perhaps RadOnc should be more along the model of Transplant Surgery Fellowship - relatively few, high-volume places that get you the cases you need, but also enough tough variations on the bread and butter + the zebras. Doesn't need to be all of the big name ivory-towers, but places with wide catchments and enough cases per resident. Midwestern program that is the only place for 400 miles - probably a good idea to keep; 6th program in NYC - probably imprudent.
 
SOAPing, sometimes, is not all that bad.
Let's say an M4 is great (high Step 1, etc. etc.) and only ranked the big 3 and nothing else.
Then those big 3 programs are filled with others.

The M4 is now not matched, he/she can SOAP and gets into Emory.
It is not like someone not matched to Derm or Ob-Gyn and used radonc as a backup.
So, in my example, this M4 is invested in radonc, and just happened to be unmatched on the first round.
We need to look out for the M4's too.
 
Radonc90 said:
SOAPing, sometimes, is not all that bad.
Let's say an M4 is great (high Step 1, etc. etc.) and only ranked the big 3 and nothing else.
Then those big 3 programs are filled with others.

The M4 is now not matched, he/she can SOAP and gets into Emory.
It is not like someone not matched to Derm or Ob-Gyn and used radonc as a backup.
So, in my example, this M4 is invested in radonc, and just happened to be unmatched on the first round.
We need to look out for the M4's too.
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The problem I have with the rad onc Twitterati is that it is a small sliver of radiation oncologists, who are content with their current positions, or current trainees who still view the world through rose-colored glasses.

They made a big deal over the past week about how this is a time for celebration and that we all should welcome our new colleagues into our big, happy rad onc family. Little do our new colleagues know the cruel truth that who they matched with this year will be their competition in 5 years, competition for the dwindling number of quality jobs.

In addition, they don't realize that it is just not this match class but also, the mid-career rad oncs who have been waiting for their next move, for any job opportunity that may present itself. If you were a partner or employer, with a stellar rad onc position to offer, who would you choose, someone who has been out for at least a couple of years and built a bustling practice or a new grad, who matched during nadir rad onc, with no track record for practice building?

The other thing that they didn't tell you is about how intense the job search is. In my class, the tension was so thick between me and my co-residents that we did not talk to each other at all and kept potential job leads to ourselves. We all went on as many interviews as we can and as early as possible, just trying to look under every rock that we can before the next person can. I can assure you, the rad onc family that we were in was fit for Jerry Springer, rather than the Brady Bunch.

Get your celebration in now and get ready to brown nose your attendings and chairs, just for a stab at being hired where you are doing residency, because in a few short years, when you are ready to look for a job, you will find out that everyone will be looking to eat your lunch.
 
I just deleted 7 posts started from someone outside our specialty spreading doom and gloom. We have enough doom and gloom in the rad onc forum, we don't need anyone from other specialties stirring that up further. That's not to say others are not allowed to post, but please do not frankly spread doom and gloom here. You can talk about your concerns in your own specialty forum.
 
SubserviantToABR said:
The problem I have with the rad onc Twitterati is that it is a small sliver of radiation oncologists, who are content with their current positions, or current trainees who still view the world through rose-colored glasses.

They made a big deal over the past week about how this is a time for celebration and that we all should welcome our new colleagues into our big, happy rad onc family. Little do our new colleagues know the cruel truth that who they matched with this year will be their competition in 5 years, competition for the dwindling number of quality jobs.

In addition, they don't realize that it is just not this match class but also, the mid-career rad oncs who have been waiting for their next move, for any job opportunity that may present itself. If you were a partner or employer, with a stellar rad onc position to offer, who would you choose, someone who has been out for at least a couple of years and built a bustling practice or a new grad, who matched during nadir rad onc, with no track record for practice building?

The other thing that they didn't tell you is about how intense the job search is. In my class, the tension was so thick between me and my co-residents that we did not talk to each other at all and kept potential job leads to ourselves. We all went on as many interviews as we can and as early as possible, just trying to look under every rock that we can before the next person can. I can assure you, the rad onc family that we were in was fit for Jerry Springer, rather than the Brady Bunch.

Get your celebration in now and get ready to brown nose your attendings and chairs, just for a stab at being hired where you are doing residency, because in a few short years, when you are ready to look for a job, you will find out that everyone will be looking to eat your lunch.
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Exactly.

My co-residents and I are fairly close, PGY2-PGY5, it doesn't matter.

I found out one of my fellow PGY5s had the first job interview of our cohort through other people. That person didn't tell us themselves till maybe ~6 weeks later.

Fortunately, the people in my department looking for jobs this year generally wanted different things, so there wasn't a ton of overlap. Still, when I was unexpectedly offered an interview in my preferred geography (my only one in that area), I told no one. That same PGY5 called me while I was traveling to the interview about something else, and asked me what I was doing. I lied and said I was visiting family. Was it necessary to hide it? Probably not. But with the ridiculous amount of hustling it took to secure this interview, I wasn't going to do anything to mess it up.

When I was offered that job (my only offer), I told NO ONE until the contract was fully executed, for the same reason.

However, we can tell these stories till we're blue in the face. The people who are listening to us - the medical students thinking about what specialty to pick, and deciding against RadOnc - are going to read the amalgam of stories on SDN and pick a different specialty. The people who read these stories and have already made up their mind that we're wrong, or think they're special and can avoid all this, or whatever - they're lost.

They won't find out they're not special until it's too late.
 
elementaryschooleconomics said:
Exactly.

My co-residents and I are fairly close, PGY2-PGY5, it doesn't matter.

I found out one of my fellow PGY5s had the first job interview of our cohort through other people. That person didn't tell us themselves till maybe ~6 weeks later.

Fortunately, the people in my department looking for jobs this year generally wanted different things, so there wasn't a ton of overlap. Still, when I was unexpectedly offered an interview in my preferred geography (my only one in that area), I told no one. That same PGY5 called me while I was traveling to the interview about something else, and asked me what I was doing. I lied and said I was visiting family. Was it necessary to hide it? Probably not. But with the ridiculous amount of hustling it took to secure this interview, I wasn't going to do anything to mess it up.

When I was offered that job (my only offer), I told NO ONE until the contract was fully executed, for the same reason.

However, we can tell these stories till we're blue in the face. The people who are listening to us - the medical students thinking about what specialty to pick, and deciding against RadOnc - are going to read the amalgam of stories on SDN and pick a different specialty. The people who read these stories and have already made up their mind that we're wrong, or think they're special and can avoid all this, or whatever - they're lost.

They won't find out they're not special until it's too late.
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I had to do the exact same thing except it was one of my attendings who I was also competing against for a job.
 
SubserviantToABR said:
The other thing that they didn't tell you is about how intense the job search is. In my class, the tension was so thick between me and my co-residents that we did not talk to each other at all and kept potential job leads to ourselves. We all went on as many interviews as we can and as early as possible, just trying to look under every rock that we can before the next person can. I can assure you, the rad onc family that we were in was fit for Jerry Springer, rather than the Brady Bunch.
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elementaryschooleconomics said:
Fortunately, the people in my department looking for jobs this year generally wanted different things, so there wasn't a ton of overlap. Still, when I was unexpectedly offered an interview in my preferred geography (my only one in that area), I told no one. That same PGY5 called me while I was traveling to the interview about something else, and asked me what I was doing. I lied and said I was visiting family. Was it necessary to hide it? Probably not. But with the ridiculous amount of hustling it took to secure this interview, I wasn't going to do anything to mess it up.
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My experience was slightly different

I chose to view the job search among my friends as “may the best person get hired”

Shared tips, job openings, interview details with close friends

Helped a friend get an interview at same practice as me bc I knew he really wanted to be in DC

My coresident and I are very close and we chose to maintain that friendship over competition. We felt like we are competing against 200 ppl so why screw over the person sitting next to each other.

Thankfully, also had a few friends at other institutions where we were all applying differently so that helped a lot in terms of having a “cheering squad” bc this process is unreal stressful

unfortunately I believe this to be atypical and I still overall kept things close to the chest. Sharing was only between ~7-8 ppl

I’ve heard many more who had the experience as @elementaryschooleconomics & @SubserviantToABR described

So sad that it’s come to this 🙁
 
radonc17 said:
We felt like we are competing against 200 ppl so why screw over the person sitting next to each other.
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It still seems almost impossible that the U.S. is producing 200 new RO jobs per year, or that it could produce ~1000 RO jobs over the next 5 years. We could factor in the steady rate of RO retirement (who knows what that rate really is) which helps to produce RO jobs. But practicing ROs instead of retiring occasionally like to look for new jobs too.
 
TheWallnerus said:
It still seems almost impossible that the U.S. is producing 200 new RO jobs per year, or that it could produce ~1000 RO jobs over the next 5 years. We could factor in the steady rate of RO retirement (who knows what that rate really is) which helps to produce RO jobs. But practicing ROs instead of retiring occasionally like to look for new jobs too.
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Many become locums after retirement and are cheaper to pay than hiring a new grad..
 
For those of you with Twitter accounts...
I don't tweet often, maybe one tweet a month or less.

- Once in a while I randomly look at my "Following" List.
Interestingly, some people (even my own radonc colleagues)...I followed them and they followed me back.
But as time goes on, I notice that some of them stop following me.
It looks like as they pick up new ppl to follow, they drop some...

Just curious, if you follow someone on Twitter, what is the primary reason for you to drop that person?
 
Radonc90 said:
Just curious, if you follow someone on Twitter, what is the primary reason for you to drop that person?
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Personally, when people tweet too many irrelevant stuff for me that shows up on my feed, I tend to unfollow.
I once followed Matthew Katz for instance, but he keeps retweeting his patients "survivor" tweets, every other day.
"I beat breast cancer 2 years ago" blablabla... It gets frustrating at some point...
:nod:
 
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