Rad Onc Twitter

[Ray D. Ayshun]

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Well that escalated quickly.


I think it is fair to call out the post for being distasteful. I just wanted to reply on the gendermongering comment— The girls death had nothing to do with it and Frostys comment was obviously sarcasm, not a genuine prediction that anybody would stoop to such a level to presuppose things about this girl and her death to further their agenda. I think they have a limit (I hope)

I have seen it all the time with this constant effort to try and twist anything they can to confirm their preheld belief that the field is methodically discriminatory and the only solution is heavy handed forceful rebalancing of things by those who know better for us.

now I will slowly back away…

The question here is, is it worthwhile to preach to the choir and alienate those that need convincing? Whatever the intent was, it doesn't help getting the message across. That's more or less the definition of trolling.

 

[RadOncMegatron]

Its precisely why I dont get these ideas that brag about how much they have their midlevels do.

First experience of autonomous, un-supervised treatment planning integrated in adaptive MR-guided radiotherapy and delivered to a patient with prostate cancer​

First experience of autonomous, un-supervised treatment planning integrated in adaptive MR-guided radiotherapy and delivered to a patient with prostate cancer

The process of radiotherapy (RT) treatment planning from simulation using computed tomography (CT) and/or magnetic resonance imaging (MRI) to the application of the first treatment fraction is currently a multi-step routine process requiring human interactions, which is fragmented and...

www.thegreenjournal.com

Yikes that AI thing is coming in faster than I expected. Although it can’t do complex sites. The impact it can have for prostate will effect us all just like breast cancer fractionation effects us. Urorads might be celebrating knowing they can hire midlevels to babysit an AI with such incredible turn around.

 

[FrostyHammer]

Yesssssss!!!!! Troll the job market, only helping some one. Not demonstrating insensitivity. The job market is bad.

Troll academic hypocrites when they are hypocrites. Like when they post a ridiculous database paper. Or when academics who are not at financially transparent institutions use social media (see thread title) to virtue signal about financial toxicity. (You are actually not trolling here, they are. You are just giving them a hard time. The data base paper and the chair job pep talk are actually digressive and extraneous. Well, you might be being inflammatory but that's your MO).

Don't troll academics when a young doctor dies!!

You got this.

For actually really smart people that contribute at such a high level in this forum (sincerely), I wonder why it’s so hard to not step back and try to see why others take issue with bringing Jagsi into this. Maybe you truly think it’s relevant. I wonder if you have the insight to see why it’s not. A young, possibly troubled young doc died. Your comment is to predict Jagsi making a eulogy that is off the mark? Huh?

If you'd like me to admit that my post was in poor taste, fine, I am OK with that. I will gladly compromise with y'all on that. Do note that I wrote my initial post on Sunday evening, and no one (including admins) said anything until Wednesday. Then all of a sudden it becomes 'incel-like' to some of you.

However- consider this: think about all the times where people on SDN are discussing a completely different topic and it just degenerates into a tangential rant on the job market. I don't need to name any specific people or threads, but I think it's easy to find them out by simply searching.

I don't particularly like those tangents, but you know what, I tolerate them knowing that #1 I am free to not read it if I so desire, and #2 I respect people's personal liberties that they can write whatever they want as long as it's not threatening or spreading blatantly false information. People posting on SDN have that right, and I respect that right.

So how is this any different of a circumstance? Are we just going to allow some people to start going in different desired directions from the topic at hand, and not others? Double standard much? This is SDN, it's not that other message board where Simul was censored for a nonsense reason. Respect other people's liberties. If you don't like it, you're free to not read/not reply just like I do with abrupt transitions in other threads from topic x to the job market. Name me one place where I made personal attacks, threatened anyone, or spread blatantly false info. If anything, y'all who used the personal attack 'incel' are the ones at fault. That crap doesn't belong on SDN.

 

[Krukenberg]

If you'd like me to admit that my post was in poor taste, fine, I am OK with that. I will gladly compromise with y'all on that. Do note that I wrote my initial post on Sunday evening, and no one (including admins) said anything until Wednesday. Then all of a sudden it becomes 'incel-like' to some of you.

However- consider this: think about all the times where people on SDN are discussing a completely different topic and it just degenerates into a tangential rant on the job market. I don't need to name any specific people or threads, but I think it's easy to find them out by simply searching.

I don't particularly like those tangents, but you know what, I tolerate them knowing that #1 I am free to not read it if I so desire, and #2 I respect people's personal liberties that they can write whatever they want as long as it's not threatening or spreading blatantly false information. People posting on SDN have that right, and I respect that right.

So how is this any different of a circumstance? Are we just going to allow some people to start going in different desired directions from the topic at hand, and not others? Double standard much? This is SDN, it's not that other message board where Simul was censored for a nonsense reason. Respect other people's liberties. If you don't like it, you're free to not read/not reply just like I do with abrupt transitions in other threads from topic x to the job market. Name me one place where I made personal attacks, threatened anyone, or spread blatantly false info. If anything, y'all who used the personal attack 'incel' are the ones at fault. That crap doesn't belong on SDN.

Very low EQ with this one

 

[RSAOaky]

Imagine if the female pilot of your regional jet explaining that she only needed 1000 hours instead of 1500 hours of training for her ATP certification because she got pregnant during training and making her make it up was sexist. What a sexist thunderstorm with sexist gusting 40 knot crosswinds. And that stupid sexist pitot Valve that clogged and didn’t tell you your airspeed. Don’t ask questions.

This is a bit of an irrational argument. Is anyone lowering standards of qualification/graduation for females who take maternity leave? To my knowledge, residents are still required to meet ACGME graduation requirements and those that don't often delay graduation to make them up. You may argue that those requirements are low but that's a completely different gripe.

 

[evilbooyaa]

If you'd like me to admit that my post was in poor taste, fine, I am OK with that. I will gladly compromise with y'all on that. Do note that I wrote my initial post on Sunday evening, and no one (including admins) said anything until Wednesday. Then all of a sudden it becomes 'incel-like' to some of you.

However- consider this: think about all the times where people on SDN are discussing a completely different topic and it just degenerates into a tangential rant on the job market. I don't need to name any specific people or threads, but I think it's easy to find them out by simply searching.

I don't particularly like those tangents, but you know what, I tolerate them knowing that #1 I am free to not read it if I so desire, and #2 I respect people's personal liberties that they can write whatever they want as long as it's not threatening or spreading blatantly false information. People posting on SDN have that right, and I respect that right.

So how is this any different of a circumstance? Are we just going to allow some people to start going in different desired directions from the topic at hand, and not others? Double standard much? This is SDN, it's not that other message board where Simul was censored for a nonsense reason. Respect other people's liberties. If you don't like it, you're free to not read/not reply just like I do with abrupt transitions in other threads from topic x to the job market. Name me one place where I made personal attacks, threatened anyone, or spread blatantly false info. If anything, y'all who used the personal attack 'incel' are the ones at fault. That crap doesn't belong on SDN.

You are allowed to post what you did, but it does not mean that folks are not allowed to criticize your post. I saw the 'incel' posts and I'll admit my own biases that I felt that your post was in pretty poor taste as well but didn't feel the need to comment as many others already had, but that at their current level those posts criticizing you don't reach the level of a warning for me.

I see two options for you on this:
1) Move on, walk away from this topic since you've admitted that your post was in poor taste (which is basically what people were saying initially before you defended it)
2) Double down - you're welcome to on this topic if you really feel it's the hill worth dying on (if SDN 'rep' means anything to you)

The more you defend a mistake and, once realizing you've made one, refuse to move on from it, the more it's going to stick. Just my 2 cents, broski.

 

[drewdog1973]

If you'd like me to admit that my post was in poor taste, fine, I am OK with that. I will gladly compromise with y'all on that. Do note that I wrote my initial post on Sunday evening, and no one (including admins) said anything until Wednesday. Then all of a sudden it becomes 'incel-like' to some of you.

However- consider this: think about all the times where people on SDN are discussing a completely different topic and it just degenerates into a tangential rant on the job market. I don't need to name any specific people or threads, but I think it's easy to find them out by simply searching.

I don't particularly like those tangents, but you know what, I tolerate them knowing that #1 I am free to not read it if I so desire, and #2 I respect people's personal liberties that they can write whatever they want as long as it's not threatening or spreading blatantly false information. People posting on SDN have that right, and I respect that right.

So how is this any different of a circumstance? Are we just going to allow some people to start going in different desired directions from the topic at hand, and not others? Double standard much? This is SDN, it's not that other message board where Simul was censored for a nonsense reason. Respect other people's liberties. If you don't like it, you're free to not read/not reply just like I do with abrupt transitions in other threads from topic x to the job market. Name me one place where I made personal attacks, threatened anyone, or spread blatantly false info. If anything, y'all who used the personal attack 'incel' are the ones at fault. That crap doesn't belong on SDN.

Different altogether.

did anyone use her death to make a point about the job market ?

 

[RSAOaky]

Just be patient everyone, we're one Ralph tweet from moving on to the next controversy

 

[TheWallnerus]

Just be patient everyone, we're one Ralph tweet from moving on to the next controversy

My son told me yesterday "Dad, no one my age is on Twitter."

 

[RadOncMegatron]

This is a bit of an irrational argument. Is anyone lowering standards of qualification/graduation for females who take maternity leave? To my knowledge, residents are still required to meet ACGME graduation requirements and those that don't often delay graduation to make them up. You may argue that those requirements are low but that's a completely different gripe.

We just have to admit there are several irresolvable conflicts let's not sugar coat it

1) Not giving maternity (and paternity?) leave SUCKS

2) If you don't have to make up the time (i think it is 12 weeks) then you admit it is not necessary, so why shouldn't every resident get 12 weeks off? I think you can take 12 weeks off for each child, but not sure if you only have a 12 week period you don't have to make, meaning if you have 2 kids and get 24 weeks off you need to make up 12 weeks.

3) It can be a hardship on these residency programs (business in general?) to lose slave labor / resident for 12 weeks. Someone else will pick up the slack.

4) Even without 12-24 weeks of residency, you still can be an excellent doctor, conversely, if you are a sorry doctor 12-24 weeks ain't gonna make you better. You are there for a total 5 years to be cheap labor

There may be no solution. Just ugliness in every direction. Sweep under the rug what you don't like! If there were a sliding scale, say if you see X number of cases and have a X score on whatever test, then you should be free to practice and to require the attendings that had the person on leave SEE THEIR OWN PATIENTS AND NOT HAVE EXTRA COVERAGE FROM ANOTHER RESIDENT.

 

[RadOncMegatron]

My son told me yesterday "Dad, no one my age is on Twitter."

Is this real life? The conclusion is "Given the disproportionate number of patients versus radiation oncology professionals active on Instagram versus Twitter, and the lack of radiation therapy-specific content on Instagram, there may be an opportunity to improve patient outreach and education by promoting presence of radiation oncologists within Instagram."

I'm telling you, my YouTube paper or something like it (hours on Instagram and Twitter correlated with Rad Onc Productivity) is gonna happen LOL

This is in PRO!?!

 

[deleted969641]

This is a bit of an irrational argument. Is anyone lowering standards of qualification/graduation for females who take maternity leave? To my knowledge, residents are still required to meet ACGME graduation requirements and those that don't often delay graduation to make them up. You may argue that those requirements are low but that's a completely different gripe.

Yes. There is a not insignificant number of people that think they are entitled to undergo less training if they (presumably choose) to have children during residency:



Are people not aware of this?

i do not want to have children. It is not important to me. I understand it is important to other people. But maybe there are things I want to do instead that are important for me that I want 12 weeks for.

im fine with giving everyone 12 weeks as long as it can be used for any sabbatical not just child rearing. But they would want another 12 weeks in addition to that…

and is this just 12 weeks PER CHILD?

i personally witnessed residents trying to plan their pregnancies with their rotation schedule so they could try and “get out of” hard rotations like head and neck

 

[OTN]

We just have to admit there are several irresolvable conflicts let's not sugar coat it

1) Not giving maternity (and paternity?) leave SUCKS

2) If you don't have to make up the time (i think it is 12 weeks) then you admit it is not necessary, so why shouldn't every resident get 12 weeks off? I think you can take 12 weeks off for each child, but not sure if you only have a 12 week period you don't have to make, meaning if you have 2 kids and get 24 weeks off you need to make up 12 weeks.

3) It can be a hardship on these residency programs (business in general?) to lose slave labor / resident for 12 weeks. Someone else will pick up the slack.

4) Even without 12-24 weeks of residency, you still can be an excellent doctor, conversely, if you are a sorry doctor 12-24 weeks ain't gonna make you better. You are there for a total 5 years to be cheap labor

There may be no solution. Just ugliness in every direction. Sweep under the rug what you don't like! If there were a sliding scale, say if you see X number of cases and have a X score on whatever test, then you should be free to practice and to require the attendings that had the person on leave SEE THEIR OWN PATIENTS AND NOT HAVE EXTRA COVERAGE FROM ANOTHER RESIDENT.

A decent solution would be to move from a "time-based" residency to a "competency-based" residency, where you're there for as long as it takes you to become proficient in the material.

There was a little momentum exploring this in the internal medicine world a decade or so ago, but it went nowhere as one would expect. Probably too tough logistically to pull off.

 

[FrostyHammer]

You are allowed to post what you did, but it does not mean that folks are not allowed to criticize your post. I saw the 'incel' posts and I'll admit my own biases that I felt that your post was in pretty poor taste as well but didn't feel the need to comment as many others already had, but that at their current level those posts criticizing you don't reach the level of a warning for me.

I see two options for you on this:
1) Move on, walk away from this topic since you've admitted that your post was in poor taste (which is basically what people were saying initially before you defended it)
2) Double down - you're welcome to on this topic if you really feel it's the hill worth dying on (if SDN 'rep' means anything to you)

The more you defend a mistake and, once realizing you've made one, refuse to move on from it, the more it's going to stick. Just my 2 cents, broski.

I am glad you came on and commented. I agree with you - folks are certainly welcome to criticize it. Using name-calling is not the way to do it, but most other ways are fine. I am also not "defending a mistake" because I think there was no mistake neither on my part nor the part of those who argued against me. These are all opinions and we should all be allowed to air them without being called incels or such names. That is why I admitted that the taste of it may have been not the best as above. But that by no means disallows me to post it either, as you mentioned.

As an admin, you did a good job putting aside your biases and addressing things to me. However what I would encourage you as the admin is, in the spirit of being balanced and being consistent, to also address the name-calling done by @communitydoc13 and @drewdog1973 - using the word 'incel' or other forms of name-calling cannot be acceptable in this forum and you as the admin should be aware of this and call it out when it happens rather than just giving it lip service. They're welcome to criticize my post, and I have nothing against anyone else who criticized the post, but I certainly believe we need to act professionally and with decorum on here, and name-calling has no place in that.

 

[deleted969641]

A decent solution would be to move from a "time-based" residency to a "competency-based" residency, where you're there for as long as it takes you to become proficient in the material.

There was a little momentum exploring this in the internal medicine world a decade or so ago, but it went nowhere as one would expect. Probably too tough logistically to pull off.

I am all for this as it would solve the pregnancy concern but the problem is that it would likely devolve into a subjective system like PhD training where people can end up spending a decade in their program due to a malignant program. In the age of the woke that is a very bad idea as people can just scream some -ism if they are hitting the milestones they think they are entitled to.

Fixed training requirements with minimum competency exams (objective meritocracy) are the only way. It would be theoretically possible (and likely probable) to pass the abr exams without spending a single day in clinic.

it Is the way of the universe that only women can have children and that process takes time away from other things. Sucks but that’s life. Can’t have your cake and eat it too otherwise you could end up with pilots flying into mountains or rad oncs that don’t know how to treat basic tonsil cancers. If you are going to allow a “get out of residency early” pass if your PD thinks you’re good to go, then you have to offer it to EVERYONE IMO. With the pregnancy situation, people can just scream sexism and that likely will push PDS to release people early they otherwise would not have cause they don’t want to deal with the blowback and possible Twitter mob shaming/cancelling or heat from the dean when the resident complains of discrimination.

 

[RadOncMegatron]

A decent solution would be to move from a "time-based" residency to a "competency-based" residency, where you're there for as long as it takes you to become proficient in the material.

There was a little momentum exploring this in the internal medicine world a decade or so ago, but it went nowhere as one would expect. Probably too tough logistically to pull off.

Oh that is a good idea. It's not good for the attending side (really no upside for them), but would be awesome. You could then stay in residency to do the research and "fellowship" portion if needed up to year 5.

 

[FrostyHammer]

Different altogether.

did anyone use her death to make a point about the job market ?

No but they are more than welcome to. I would have no gripes at all. They have the rights and personal liberties to do it if they wish.

 

[TheWallnerus]

A decent solution would be to move from a "time-based" residency to a "competency-based" residency, where you're there for as long as it takes you to become proficient in the material.

There was a little momentum exploring this in the internal medicine world a decade or so ago, but it went nowhere as one would expect. Probably too tough logistically to pull off.

This sounds like chia coin (proof of spacetime) vs bitcoin (proof of work).

I like it. I don’t think chia will make it.

 

[FrostyHammer]

I am all for this as it would solve the pregnancy concern but the problem is that it would likely devolve into a subjective system like PhD training where people can end up spending a decade in their program due to a malignant program. In the age of the woke that is a very bad idea as people can just scream some -ism if they are hitting the milestones they think they are entitled to.

Fixed training requirements with minimum competency exams (objective meritocracy) are the only way. It would be theoretically possible (and likely probable) to pass the abr exams without spending a single day in clinic.

it Is the way of the universe that only women can have children and that process takes time away from other things. Sucks but that’s life. Can’t have your cake and eat it too otherwise you could end up with pilots flying into mountains or rad oncs that don’t know how to treat basic tonsil cancers. If you are going to allow a “get out of residency early” pass if your PD thinks you’re good to go, then you have to offer it to EVERYONE IMO. With the pregnancy situation, people can just scream sexism and that likely will push PDS to release people early they otherwise would not have.

I agree, but perhaps a good alternative is to create a separate clinical track/path for some residents like Holman does for research track. If a resident knows they want to be clinical focused, there should be a separate path for 3-year radonc residency that's all clinic based with increased case numbers required to support it (Holman requires less case number).

 

[deleted969641]

I agree, but perhaps a good alternative is to create a separate clinical track/path for some residents like Holman does for research track. If a resident knows they want to be clinical focused, there should be a separate path for 3-year radonc residency that's all clinic based with increased case numbers required to support it (Holman requires less case number).

Lol so you want to take away their „research“ time (up to a year at many places now)?

Gpod luck with thät

Personallz I would have loved to forgo „research“ time and finish one year early to get out in PP and be working much harder for much more $$$. That time spent generating a few retrospective reviews to go in throwaway journals is an enormous opportunity cost

 

[evilbooyaa]

I am glad you came on and commented. I agree with you - folks are certainly welcome to criticize it. Using name-calling is not the way to do it, but most other ways are fine. I am also not "defending a mistake" because I think there was no mistake neither on my part nor the part of those who argued against me. These are all opinions and we should all be allowed to air them without being called incels or such names. That is why I admitted that the taste of it may have been not the best as above. But that by no means disallows me to post it either, as you mentioned.

As an admin, you did a good job putting aside your biases and addressing things to me. However what I would encourage you as the admin is, in the spirit of being balanced and being consistent, to also address the name-calling done by @communitydoc13 and @drewdog1973 - using the word 'incel' or other forms of name-calling cannot be acceptable in this forum and you as the admin should be aware of this and call it out when it happens rather than just giving it lip service. They're welcome to criticize my post, and I have nothing against anyone else who criticized the post, but I certainly believe we need to act professionally and with decorum on here, and name-calling has no place in that.

As always, report a post if you feel it crosses a line.

I, personally, disagree with you on the line in the regard of those other posts and whether it crossed the line, but if you report a post we generally get the input of mods from outside the RO forum to have an impartial (at least as impartial as another moderator of SDN can be) view of the thread.

 

[FrostyHammer]

Lol so you want to take away their „research“ time (up to a year at many places now)?

Gpod luck with thät

Personallz I would have loved to forgo „research“ time and finish one year early to get out in PP and be working much harder for much more $$$. That time spent generating a few retrospective reviews to go in throwaway journals is an enormous opportunity cost

Nah it'd be an option just like Holman pathway is. Why have the ACR/ABR/whoever mandate everyone to do x months of research time if they don't want to do it? If trainees know they don't want to do research as part of a career, just let them apply for a clinical track pathway as their option.

 

[CaesarRO]

A decent solution would be to move from a "time-based" residency to a "competency-based" residency, where you're there for as long as it takes you to become proficient in the material.

There was a little momentum exploring this in the internal medicine world a decade or so ago, but it went nowhere as one would expect. Probably too tough logistically to pull off.

Dan Golden is trying to work towards this. He and Elizabeth Jeans (Mayo resident with a Masters in Ed) have been working on creating a standardized consensus for competencies.

There is quite a bit of good work coming out of ROECSG on this front, but it's all slow-moving and takes time to do rigorously.

 

[RickyScott]

Dan Golden is trying to work towards this. He and Elizabeth Jeans (Mayo resident with a Masters in Ed) have been working on creating a standardized consensus for competencies.

There is quite a bit of good work coming out of ROECSG on this front, but it's all slow-moving and takes time to do rigorously.

Normally this would be a great idea, but do we need to accelerate training times in this job market? Otherwise, given type of candidates flooding the field currently, not a bad idea to ensure competencies.

 

[ROforbetterorworse]

My son told me yesterday "Dad, no one my age is on Twitter."

WTF is this…

This makes me extra cringe seeing it’s from the ivory tower. Aren’t they supposed to be research “leaders” and have resources, etc??

can anyone share PDF?

I haven’t paid my ASTRO dues in years so no access

 

[ROforbetterorworse]

Dan Golden is trying to work towards this. He and Elizabeth Jeans (Mayo resident with a Masters in Ed) have been working on creating a standardized consensus for competencies.

There is quite a bit of good work coming out of ROECSG on this front, but it's all slow-moving and takes time to do rigorously.

Per ACGME rules, PD and residency committee already have the power to promote or demote a resident based on their competency regardless of their case count

 

[Neuronix]

Post was deleted for responding to a user that their *** would have been banned.

No calling out individual users and no swearing even if it is filtered.

Also I am very disturbed in general by the discussion surrounding a tragic young radiation oncology resident's death. I am considering action but I just do not have the time to do a deep dive on this right now. You have been warned. Please help me by reporting specific posts that are actionable.

 

[ROforbetterorworse]

Per ACGME rules, PD and residency committee already have the power to promote or demote a resident based on their competency regardless of their case count

Also what do people feel about standardized competency?

IMO it’s anti competitive in nature. If all training is equal than programs with phenomenal training at non-ideal locations will suffer

On top of that, it will raise trash program standards which will then be hard to justify shutting down

 

[RSAOaky]

Yes. There is a not insignificant number of people that think they are entitled to undergo less training if they (presumably choose) to have children during residency:



Are people not aware of this?

i do not want to have children. It is not important to me. I understand it is important to other people. But maybe there are things I want to do instead that are important for me that I want 12 weeks for.

im fine with giving everyone 12 weeks as long as it can be used for any sabbatical not just child rearing. But they would want another 12 weeks in addition to that…

and is this just 12 weeks PER CHILD?

i personally witnessed residents trying to plan their pregnancies with their rotation schedule so they could try and “get out of” hard rotations like head and neck

I'm not going to read the full article just for the purpose of making an argument. However, the radonc requirements are for 36 months in clinic and x number of cases. This is how programs are able to give residents a year of research. If a resident fulfills these requirements, they should graduate on time. If a resident does not fulfill these requirements, they should remain a resident until they do. One could argue that, if a Holman pathway allows us to graduate (and declare clinically competent) residents after only 24 months of clinical training, then in theory other residents could be declared clinically competent with < 36 months of training, but I think this is a very slippery slope and not one I agree with.

If residents plan their pregnancies around their rotation schedule that's awful and it does everyone a disservice, that is a point I agree with.

I'm not sure why you think that you're the victim/being wronged here. In your mind a woman gets 12 weeks of vacation just for going through 38 weeks of pregnancy and then pushing a watermelon out of her vagina, but YOU'RE the one whose being penalized by your lack of a 12 week sabbatical for your decision to not have kids? If you can't recognize how ass backwards that thinking is then there's probably no sense in arguing at all.

 

[Neuronix]

As long as men get paternity leave when women get maternity leave, parental leave is just fine.

The time can come out of elective/research time to still graduate on time.

I don't see any issue.

 

[Mandelin Rain]

Missing 12 weeks of clinic is too much?

What if I told you about a “pathway” where residents miss 21 MONTHS of clinic….?

 

[RadOncMegatron]

Missing 12 weeks of clinic is too much?

What if I told you about a “pathway” where residents miss 21 MONTHS of clinic….?

hahaha yes I think we are identifying multiple issues. Is the prb missing 12 weeks due to a baby? Or the prob. not to release the trade secret that we don't need 21 months of clinic? (ok I think missing almost 2 years is too much, but surely 6 mo is ok)?

 

[thecarbonionangle]

Are people really planning pregnancies to avoid work, “hard” rotations”? This sounds like FAKE NEWS to me.

 

[mheat3]

What if I told you about a “pathway” where residents miss 21 MONTHS of clinic….?

"30 for 30" Voice...

 

[deleted969641]

As long as men get paternity leave when women get maternity leave, parental leave is just fine.

The time can come out of elective/research time to still graduate on time.

I don't see any issue.

And for those of who do not want or cannot have children? Do we get the same time to pursue whatever is important to us outside of work? Why is it so much to ask that the same rules apply to everybody?

I think it is absurd to treat the choice to have children at a specific time as some sacrosanct right that supersedes everything else.

If it were an unplanned pregnancy, I would absolutely have compassion, and I think we should create an environment where people who are in these situations are absolutely supported and can feel free to come forward, but the idea that it is a deliberate lifestyle choice (it certainly is for me!) has been hammered in our heads our whole lives, and well, you can't have it both ways. I have seen people try to strategically game the whole thing many times. Children are not these things you just choose to have when it's convenient for you then just dump them in daycare so you can have your career too. I think they are actually a pretty big thing and hence why I forego all of that.

I love the idea of having 12 months of elective for everyone (actually lets make it 6 months - time is precious). You want to use that for having children? Great. You want to use that for research? Great. You want to use that to surf in Australia? Great. You want to use that to stay in clinic and write notes? Great. The problem is that many who choose to have kids look would look at those who do something else and say, wait I ALSO want to take a long vacation and do research out of clinic. I have again personally seen this where someone was miffed they had to burn vacation for maternity leave.

n your mind a woman gets 12 weeks of vacation just for going through 38 weeks of pregnancy and then pushing a watermelon out of her vagina, but YOU'RE the one whose being penalized by your lack of a 12 week sabbatical for your decision to not have kids? If you can't recognize how ass backwards that thinking is then there's probably no sense in arguing at all.

See above regarding the methodical planning of child-bearing. You are talking about something else.

Post was deleted for responding to a user that their *** would have been banned.

No calling out individual users and no swearing even if it is filtered.

Also I am very disturbed in general by the discussion surrounding a tragic young radiation oncology resident's death. I am considering action but I just do not have the time to do a deep dive on this right now. You have been warned. Please help me by reporting specific posts that are actionable.

I did not call out an individual user, I referenced #WWC and I wasn't aware that using the a-word was censure-worthy. I highly doubt that it was my use of the slang for a donkey that offended somebody rather than my criticism of #WWC. Is it permitted to criticize #WWC here? It seems like not, which was my original point I was trying to make that got subsequently deleted. I personally feel that the whole #WWC thing promulgates a false narrative. But that's just my opinion. It is curious if one cannot state that here.

Again, this topic has nothing to do with the person who died. It just transitioned to it from in an an unfortunate way.

 

[deleted969641]

Are people really planning pregnancies to avoid work, “hard” rotations”? This sounds like FAKE NEWS to me.

It happens more in more work-intense residencies like IM, but I have seen it in rad onc. The exception, and not the rule, but it definitely happens. If you were pregnant and you had the option to set your maternity leave such that you miss 2 months of ICU nights or 2 months of outpatient allergy clinic, would you just let the cards fall where they may or change your rotation preferences on the annual rank list with that knowledge in mind?

 

[ROforbetterorworse]

And for those of who do not want or cannot have children? Do we get the same time to pursue whatever is important to us outside of work? Why is it so much to ask that the same rules apply to everybody?

I think it is absurd to treat the choice to have children at a specific time as some sacrosanct right that supersedes everything else.

If it were an unplanned pregnancy, I would absolutely have compassion, and I think we should create an environment where people who are in these situations are absolutely supported and can feel free to come forward, but the idea that it is a deliberate lifestyle choice (it certainly is for me!) has been hammered in our heads our whole lives, and well, you can't have it both ways. I have seen people try to strategically game the whole thing many times. Children are not these things you just choose to have when it's convenient for you then just dump them in daycare so you can have your career too. I think they are actually a pretty big thing and hence why I forego all of that.

I love the idea of having 12 months of elective for everyone (actually lets make it 6 months - time is precious). You want to use that for having children? Great. You want to use that for research? Great. You want to use that to surf in Australia? Great. You want to use that to stay in clinic and write notes? Great. The problem is that many who choose to have kids look would look at those who do something else and say, wait I ALSO want to take a long vacation and do research out of clinic. I have again personally seen this where someone was miffed they had to burn vacation for maternity leave.


See above regarding the methodical planning of child-bearing. You are talking about something else.


I did not call out an individual user, I referenced #WWC and I wasn't aware that using the a-word was censure-worthy. I highly doubt that it was my use of the slang for a donkey that offended somebody rather than my criticism of #WWC. Is it permitted to criticize #WWC here? It seems like not, which was my original point I was trying to make that got subsequently deleted. I personally feel that the whole #WWC thing promulgates a false narrative. But that's just my opinion. It is curious if one cannot state that here.

Again, this topic has nothing to do with the person who died. It just transitioned to it from in an an unfortunate way.

I don’t think you’re gonna get much support on this

nobody giving you 12 weeks off to surf in Australia

First 12 weeks of newborn isn’t fun and games like surfing

 

[deleted969641]

I don’t think you’re gonna get much support on this

nobody giving you 12 weeks off to surf in Australia

First 12 weeks of newborn isn’t fun and games like surfing

You missed my point entirely.

Some want the training requirement reduced for certain life activities. My point is that's fine as long as everyone gets that time to do with it whatever they want.

I understand that some people think surfing in Australia is a poor use of time. Maybe it's important to me? For me, 12 weeks of a newborn is not something I want. So some people get time off for things they want, but I don't get time off for things I want? (For reference, I don't surf but was making a point). Maybe I want to take 12 weeks to spend with my dying parent. Maybe I want to take 12 weeks to play video games. What does it matter? If you are going to allow some people to take time off away from anything related to radiation oncology, then you need to allow everyone to take time off from anything related to radiation oncology without having to make it up. Not only having exceptions for things baby related. Same training requirements for everybody. How is that not fair?

I'm aware that I'm not going to get much support on this because it gives people funny feelings. I'm convinced my logic is sound though. Unfortunately my sound logic has a tendency to get me in trouble.

 

[ROforbetterorworse]

You missed my point entirely.

Some want the training requirement reduced for certain life activities. My point is that's fine as long as everyone gets that time to do with it whatever they want.

I understand that some people think surfing in Australia is a poor use of time. Maybe it's important to me? For me, 12 weeks of a newborn is not something I want. So some people get time off for things they want, but I don't get time off for things I want? (For reference, I don't surf but was making a point). Maybe I want to take 12 weeks to spend with my dying parent. Maybe I want to take 12 weeks to play video games. What does it matter? If you are going to allow some people to take time off away from anything related to radiation oncology, then you need to allow everyone to take time off from anything related to radiation oncology without having to make it up. Not only having exceptions for things baby related. Same training requirements for everybody. How is that not fair?

I'm aware that I'm not going to get much support on this because it gives people funny feelings. I'm convinced my logic is sound though. Unfortunately my sound logic has a tendency to get me in trouble.

i view elective time as non radonc related time to better yourself as an all rounder

our field salivates over it being research bc that’s their priority of what makes someone worthy of b

If you don’t choose research I would expect It to be something else that improves you clinically in some way

so when elective time is lost for parental leave, it’s a loss bc now you’re stuck only doing radonc and you’ve lost chance to benefit yourself in workplace

this is fine bc as you alluded it’s their choice

But it’s not meant to give yourself an extra one year of vacation

 

[Lamount]

You missed my point entirely.

Some want the training requirement reduced for certain life activities. My point is that's fine as long as everyone gets that time to do with it whatever they want.

I understand that some people think surfing in Australia is a poor use of time. Maybe it's important to me? For me, 12 weeks of a newborn is not something I want. So some people get time off for things they want, but I don't get time off for things I want? (For reference, I don't surf but was making a point). Maybe I want to take 12 weeks to spend with my dying parent. Maybe I want to take 12 weeks to play video games. What does it matter? If you are going to allow some people to take time off away from anything related to radiation oncology, then you need to allow everyone to take time off from anything related to radiation oncology without having to make it up. Not only having exceptions for things baby related. Same training requirements for everybody. How is that not fair?

I'm aware that I'm not going to get much support on this because it gives people funny feelings. I'm convinced my logic is sound though. Unfortunately my sound logic has a tendency to get me in trouble.

Moral relativism is always a reasonable argument... to a point. All reasons for being out of work aren't created equal. One isn't allowed to call in "sick" and then go surfing.

That being said, I think each residency should get to decide how their residents spend their "research year"... so long as both men and woman can take 12 weeks maternity/paternity leave for a child (which can come out of that year). My thoughts are that your residency should be ALLOWED to let you surf for a year so long as you fulfill your 36 months in clinic... but they should be REQUIRED to let you use 12 weeks of your 4 years for maternity/paternity leave.

 

[RSAOaky]

And for those of who do not want or cannot have children? Do we get the same time to pursue whatever is important to us outside of work? Why is it so much to ask that the same rules apply to everybody?

I think it is absurd to treat the choice to have children at a specific time as some sacrosanct right that supersedes everything else.

If it were an unplanned pregnancy, I would absolutely have compassion, and I think we should create an environment where people who are in these situations are absolutely supported and can feel free to come forward, but the idea that it is a deliberate lifestyle choice (it certainly is for me!) has been hammered in our heads our whole lives, and well, you can't have it both ways. I have seen people try to strategically game the whole thing many times. Children are not these things you just choose to have when it's convenient for you then just dump them in daycare so you can have your career too. I think they are actually a pretty big thing and hence why I forego all of that.

I love the idea of having 12 months of elective for everyone (actually lets make it 6 months - time is precious). You want to use that for having children? Great. You want to use that for research? Great. You want to use that to surf in Australia? Great. You want to use that to stay in clinic and write notes? Great. The problem is that many who choose to have kids look would look at those who do something else and say, wait I ALSO want to take a long vacation and do research out of clinic. I have again personally seen this where someone was miffed they had to burn vacation for maternity leave.

Someone who breaks a limb isn't being rewarded with sick leave.
Someone whose family member dies isn't being rewarded with bereavement time.
Someone who chooses to have a kid isn't being rewarded with paternity/maternity leave, and you're not being penalized for not having kids.

There is never a good time to have children and, I hate that I even have to say this, it's not that easy to time. You act like you're surrounded by some big conspiracy where everyone around you is getting pregnant and gaming the system so that they don't have to work. Your world view and the world view of those that think like you is EXACTLY why organizations that empower women and promote womens' rights exist in the first place, and based on this conversation thank god they do.

For the record, I don't have any kids nor do I intend to have any kids. I had helped with attending coverage when some of my coresidents did and I also watched coresidents who waited till after residency when it was "the right time" to have kids and struggled through fertility treatments and IVF. The right time to have a kid is when you want a kid and women shouldn't have to jump through hoops to pick a time that's convenient for everyone around them.

 

[thecarbonionangle]

The sad truth is we could graduate in 3 years like many “leaders” did. They expanded training due to oversupply and now it is impossible to go back to 3 without worsening the problem. I know of places where the research year is basically do whatever you want: locum, go to international electives, do useless research, surf, get an MBA or MPH. We have basically already admitted this is totally useless for clinical competency by allowing this flexibility.
I think the so called “research” year should be done away and only allow holman. Your job is to treat patients and cure cancer. Go get your useless MBA on your own dime and time.

 

[deleted969641]

Someone who breaks a limb isn't being rewarded with sick leave.
Someone whose family member dies isn't being rewarded with bereavement time.
Someone who chooses to have a kid isn't being rewarded with paternity/maternity leave, and you're not being penalized for not having kids.

There is never a good time to have children and, I hate that I even have to say this, it's not that easy to time. You act like you're surrounded by some big conspiracy where everyone around you is getting pregnant and gaming the system so that they don't have to work. Your world view and the world view of those that think like you is EXACTLY why organizations that empower women and promote womens' rights exist in the first place, and based on this conversation thank god they do.

For the record, I don't have any kids nor do I intend to have any kids. I had helped with attending coverage when some of my coresidents did and I also watched coresidents who waited till after residency when it was "the right time" to have kids and struggled through fertility treatments and IVF. The right time to have a kid is when you want a kid and women shouldn't have to jump through hoops to pick a time that's convenient for everyone around them.

I'm sorry, but I completely disagree with you. Planning a family is not the same as a family member's death or a serious injury. The latter events are not planned, and the former often is. Even though it's not planned down to the second or even the week, it's still planned. You are trying to do something and you have a reasonable expectation of a certain outcome within a certain timeframe.

The reality is that pregnancies occur in different ways. I am certainly not advocating for abstinence and don't care what people do with their bodies. But there is a difference between methodical family planning and a resident going to her PD saying I'm pregnant, I didn't plan this and I don't know what to do, I don't want to ruin my career, please help me. Would you agree those two situations are different?

All of this is really besides the point. The question is whether the training time is important. If it is, then there should be no exceptions. If the training time is not important, then everybody gets the same exception and we should probably revisit how we even came up with those timeframes in the firstplace. I don't think it's right to carve out this special scenario that says "if you get pregnant then you only need X weeks of training in clinic compared to Y weeks if you don't," which is what was being argued for.

 

[xrt123]

I had my first kid in residency and used it to avoid work. I am a male and I thank my residency for giving me the time off. I grew up in a large city where many people use children and pregnancy to game the system or use it to their advantage. To pretend this is not common is idiocy. It doesn't mean having kids is not a worthwhile endeavor. Its the greatest thing I have ever done. But when I did my PhD and I saw how kids were used as an excuse to graduate early or not do work and I about lost my mind and probably had a few strokes that went undiagnosed. I fully support those not having kids to argue on their own behalf for extra time off or whatever it is that they want.

 

[Chartreuse Wombat]

Someone who breaks a limb isn't being rewarded with sick leave.
Someone whose family member dies isn't being rewarded with bereavement time.
Someone who chooses to have a kid isn't being rewarded with paternity/maternity leave, and you're not being penalized for not having kids.

There is never a good time to have children and, I hate that I even have to say this, it's not that easy to time. You act like you're surrounded by some big conspiracy where everyone around you is getting pregnant and gaming the system so that they don't have to work. Your world view and the world view of those that think like you is EXACTLY why organizations that empower women and promote womens' rights exist in the first place, and based on this conversation thank god they do.

For the record, I don't have any kids nor do I intend to have any kids. I had helped with attending coverage when some of my coresidents did and I also watched coresidents who waited till after residency when it was "the right time" to have kids and struggled through fertility treatments and IVF. The right time to have a kid is when you want a kid and women shouldn't have to jump through hoops to pick a time that's convenient for everyone around them.

I think you have contradicted yourself. On one hand you say that someone is not penalized for not having kids but then you admit that your helped with coverage for those that did. It is arguable that you were "punished" by taking on more work.

It is virtuous of you to help cover for your colleagues. We need more of this.

I was a PD for nearly 20 years and was on the ACGME RRC. I have experienced first-hand residents timing their pregnancies to coincide with more difficult rotations and also using the research time for childbearing. There are downstream effects of these choices. In the first instance clinical coverage is made more difficult and in the second case research productivity is likely to be reduced. Actions have consequences.

I expect that many on this board will criticize me for pointing this out; e.g. programs shouldn't rely on resident labor. The reality is that graded responsibilities with appropriate supervision leads to the best residents. My expectation of residents is that they should prioritize their training while in residency. This is not to say that they should not have children only that there are consequences of choosing to do so. Of course I am old and many will label me as a dinosaur or worse.

The ABMS has just recently announced "a progressive leave policy" that is to be implemented this month.

ABMS Announces Progressive Leave Policy for Residents and Fellows

CHICAGO – July 13, 2020—The American Board of Medical Specialties (ABMS), the leading not-for-profit organization that oversees physician certification in the...

www.abms.org

 

[ROforbetterorworse]

I had my first kid in residency and used it to avoid work. I am a male and I thank my residency for giving me the time off. I grew up in a large city where many people use children and pregnancy to game the system or use it to their advantage. To pretend this is not common is idiocy. It doesn't mean having kids is not a worthwhile endeavor. Its the greatest thing I have ever done. But when I did my PhD and I saw how kids were used as an excuse to graduate early or not do work and I about lost my mind and probably had a few strokes that went undiagnosed. I fully support those not having kids to argue on their own behalf for extra time off or whatever it is that they want.

you took on a lifetime of work just to avoid a few weeks of radonc residency?

residency ain’t that hard lol

 

[deleted969641]

I had my first kid in residency and used it to avoid work. I am a male and I thank my residency for giving me the time off. I grew up in a large city where many people use children and pregnancy to game the system or use it to their advantage. To pretend this is not common is idiocy. It doesn't mean having kids is not a worthwhile endeavor. Its the greatest thing I have ever done. But when I did my PhD and I saw how kids were used as an excuse to graduate early or not do work and I about lost my mind and probably had a few strokes that went undiagnosed. I fully support those not having kids to argue on their own behalf for extra time off or whatever it is that they want.

Thank you for at least being honest about it. Hell Heck, I am not even above saying I definitely wouldn't do it myself if I actually wanted kids. I'd like to think I wouldn't but who knows. Maybe one day I'll find a woman who actually puts up with my crap and I get a little surprise and my situation changes. So yeah, who knows.

I still would never work for f'ing evicore though. Those little S____s are going to public school if they have to.

 

[RSAOaky]

All of this is really besides the point. The question is whether the training time is important. If it is, then there should be no exceptions. If the training time is not important, then everybody gets the same exception and we should probably revisit how we even came up with those timeframes in the firstplace. I don't think it's right to carve out this special scenario that says "if you get pregnant then you only need X weeks of training in clinic compared to Y weeks if you don't," which is what was being argued for.

I agree with this. If the requirement is 36 months of clinic that should be the requirement for everyone.

 

[communitydoc13]

IMO both men and women should get designated maternity/paternity leave. If you don't have kids you don't get it. If you have to add time at the end, fine. The progressive leave policy above is helpful.

Providing maternal/paternal leave is a societal benefit. We should be encouraging young professional couples to have children in my opinion. It is interesting to me that people resent others parental leave so much. I didn't take any despite having multiple children in residency. I wish I had.

There are consequences and parents are in general punished professionally in our field, everyone knows this. This is endemic to our culture. You can't have it all. Among your colleagues (both male and female), were the ones who had children young and shared parental responsibility equally with their spouse viewed as favorably as those whose spouse took on the bulk of parental demands while they put in extra time at work for career development?

Among the women I trained with, the ones who were ascendant in their academic career trajectory (at least early on) all deferred having children. Among the men, the ascendant ones either had a partner who provided the bulk of parental care or again deferred parenting. The response to parenting is a big reason why MD/PhDs are less productive ultimately in terms of academic career. A commitment to parenting will by definition diminish your commitment to work.

FWIW, all the women that I knew in residency who got pregnant worked very hard, were cognizant of the hard work others were doing on their behalf and tried hard to pay it back.

 

[OTN]

“There are consequences and parents are in general punished professionally in our field, everyone knows this.”

This has honestly not been my experience, either in training or after.