Rad Onc Twitter

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Dare2Dream said:
Can't believe you don't add an extra fraction if patient is not having watery stools by the end a la skin isn't red enough in breast RT!
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Man I'm like a modern-day Strandqvist!

My in vivo dosimetry consists of an abacus and this graph:

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jondunn said:
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I would not give a prostatectomy to any PCa patient regardless the risk factors or age.

But I am a rad onc, thus we can all agree it's not good for me to give prostatectomies. I do however give a copy of my consult note (and a nice Xmas card) to the referring urologist.
 
jondunn said:
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I'm curious what the breakdown would be if the question were changed a little bit to "how would you have your intermediate risk GG2 prostate cancer managed at ages 45, 50, 60 and 70" . This is after all, what drives the tone of our consults and ultimately the question many patients want the answer to.
 
elementaryschooleconomics said:
That tweet drove me nuts.

How about: "As a physician, I recognize that there are innumerable nuances to the practice of medicine, and I don't predetermine hard lines in the sand".
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But a urologist is loathe to use the words "don't" and "hard" in the same sentence.
 
I'm absolutely rolling with laughter about this peer review thread:

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RALPH: ENOUGH.

You are so far removed from relevancy at this point it's shocking.

Anyone who has ever spent more than 5 minutes in an academic environment (or really, any professional environment) knows that the threat of retaliation is very real, and very likely. In Radiation Oncology, the crusty old academicians hold all of the power. You guys don't retire. You camp out in your leadership positions FOR DECADES. If one of us "kids" - in this specialty, anyone under 55, as far as I can tell - dares transgress one of you, it could affect us FOREVER.

To be clear, RadOnc is not unique in this respect. We're just very, very small. Perceived slights and grudges carry FAR more consequences than a specialty like Internal Medicine, where sheer numbers dilute ramifications.

We're fast approaching a date (or we might already be there) where attending Radiation Oncologists were BORN the same year the Hellman/Weichselbaum paper came out. Is that OK? Are we OK with that?

I'm not.
 
BobbyHeenan said:
It’s such a mystery why an anonymous environment in rad onc has such value.
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Wait, I'm confused (and not a reviewer)! I thought anonymous peer review was the long held standard (was for most of the journals I was submitting to back in my research years). Is anonymous peer review not the standard now. Did this change in the 2000s?

Now I remember anonymity not being perfectly well protected and my PI from the 90s figuring out who reviewers were on occasion.

Of course, IMO, the best system would be double anonymous peer review. Hell, anonymize institutional affiliation. Imagine the leveling consequences of that.

What radonc journals have anonymous vs named reviewers?
 
communitydoc13 said:
Wait, I'm confused (and not a reviewer)! I thought anonymous peer review was the long held standard (was for the journals I was submitting to back in my research years). Is anonymous peer review not the standard now. Did this change in the 2000s?

Now I remember anonymity not being perfectly well protected and my PI from the 90s figuring out who reviewers were on occasion.

Of course, IMO, the best system would be double anonymous peer review. Hell, anonymize institutional affiliation. Imagine the leveling consequences of that.

What radonc journals have anonymous vs named reviewers?
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In my experience (and I've reviewed for a lot of RadOnc and non-RadOnc journals), it doesn't appear consistent. Sometimes I've gotten manuscripts that have been anonymized, sometimes they have not.

It's very confusing to me - in the bench science world, at least in my experience, things always seemed anonymous.

Who knows.
 
elementaryschooleconomics said:
in the bench science world, at least in my experience, things always seemed anonymous
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I actually have a hard time understanding the value of non-anonymized reviews. I have seen critiques of anonymity and certainly anonymity engenders abuse, but lets think what being a non-anonymized junior reviewer means.

It means that your reviews are a commodity for your professional advancement. It means you will call out a small Chinese group that nobody's heard of but may put extra time into giving a particularly thoughtful (and positive) review to folks who might matter to your career. In a field as small as radonc, this is a disaster.
 
RealSimulD said:
I’m just having fun with them - I know they are right that non anonymous would be a shark pit, just enjoy seeing their answers.
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Oh believe me, it's very clear what you're doing!

(to me at least...Ralph? well, he locked himself out of Twitter and needed to have his spouse save him...so...)
 
Reviews have always been anonymous in my experience. I wish some reviewers would put more effort into their critiques though. Some give detailed point by point reviews and others it's like why did you even bother.
 
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1) I really like Tyler and his Tweets, this comment is not critical of him.

2) Do Tyler and I practice in the same medical specialty? What is this "small, collegial field" he's talking about? Is it Neurosurgery?

I sometimes encounter this opinion in the wild, that RadOnc is "collegial". I do think, on average, the majority of us are great people. HOWEVER, let's say, conservatively, 10-20% of us are NOT awesome/collegial/whatever.

Unfortunately, in my experience, there's a good amount of overlap between people who I know hold grudges/will sabotage you, and people who are in positions of power (academic RadOnc power, not real power, of course). It's just so easy to torpedo someone when the field is so small. I don't hold any high-level RadOnc positions at the moment, but my personal network is big enough that I am absolutely certain I could cause some level of career damage to an individual if I tried. It's crazy.

Over the years, I have learned that it is possible to find clusters of "nice" RadOncs, and that the individuals and environments that I know to be "troubled" are not universal truths. There are a lot of regular posters on here, for example, who seem absolutely wonderful to work with.

Being collegial is inversely correlated to institutional and personal prestige.
 
Manuscript submissions should be anonymous, reviewers should be anonymous. If a reviewer is aware of who wrote the paper (word of mouth, saw the abstract presented, whatever...) they should recuse themselves.

Obviously, this isn't possible with the highest profile studies, but it certainly is for most of the schlock published these days.

Make the data and analysis important, not the name/institution.
 
Mandelin Rain said:
Manuscript submissions should be anonymous, reviewers should be anonymous. If a reviewer is aware of who wrote the paper (word of mouth, saw the abstract presented, whatever...) they should recuse themselves.

Make the data and analysis important, not the name/institution.
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Yep.... Happens during oral exams all the time
 
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Rather than start another thread, I figured I'd just post this here:

1642006585488.png


I don't know if I've seen this before. ERAS releases data on students applying to multiple specialties. If you look at the first column and follow your row of interest left to right, you'll see how many students cross-applied to each specialty.

So it looks like, for RadOnc, 410 of the 763 applicants also applied to Internal Medicine - Categorical.

This is interesting, ERAS shares a lot of things I didn't know about!
 
elementaryschooleconomics said:
Rather than start another thread, I figured I'd just post this here:

View attachment 348185

I don't know if I've seen this before. ERAS releases data on students applying to multiple specialties. If you look at the first column and follow your row of interest left to right, you'll see how many students cross-applied to each specialty.

So it looks like, for RadOnc, 410 of the 763 applicants also applied to Internal Medicine - Categorical.

This is interesting, ERAS shares a lot of things I didn't know about!
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Probably because they can and also econ majors need a data set to work with. Eras seems the perfect place.
 
elementaryschooleconomics said:
Rather than start another thread, I figured I'd just post this here:

View attachment 348185

I don't know if I've seen this before. ERAS releases data on students applying to multiple specialties. If you look at the first column and follow your row of interest left to right, you'll see how many students cross-applied to each specialty.

So it looks like, for RadOnc, 410 of the 763 applicants also applied to Internal Medicine - Categorical.

This is interesting, ERAS shares a lot of things I didn't know about!
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Gotta have a back up in case you can't match Internal Medicine.

Smart!
 
Mandelin Rain said:
This may be based on the ERAS application of the current rad onc residents (i.e. 4 years worth of residents, PGY2-PGY5). 763 is about ~190ish per year, which sounds right.
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Not sure. Here's 2017, closer to peak:
1642013474305.png

Just means the secrets out, and those 200 or so that used to apply to whatever garbage specialty are throwing some our way. The trend is increasing numbers each year since 2017.
 
Well, I guess I have no idea then.

The match rate was never <50% for Rad Onc to my knowledge, so I have a hard time believing 763 applied for about 200 spots this year. Hard to rectify that (or the 2017 data) when reviewing the data below. In 2017, near peak competition, when essentially every applicant applied to every program, the average program only got 176 applications and a total of 284 unique people were interviewed.


1642018405872.png
 
But yes, if 763 people applied this year, forget about a market driven solution to overtraining.
 
Mandelin Rain said:
But yes, if 763 people applied this year, forget about a market driven solution to overtraining.
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Hard to make sense of all that too, as one graph is number of ranking applicants, which is to say, there may be a couple hundred that don't get interviewed and rank nobody, etc. The math can work i think.
 
elementaryschooleconomics said:
Rather than start another thread, I figured I'd just post this here:

View attachment 348185

I don't know if I've seen this before. ERAS releases data on students applying to multiple specialties. If you look at the first column and follow your row of interest left to right, you'll see how many students cross-applied to each specialty.

So it looks like, for RadOnc, 410 of the 763 applicants also applied to Internal Medicine - Categorical.

This is interesting, ERAS shares a lot of things I didn't know about!
Click to expand...

RealSimulD said:
763 applicants?
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elementaryschooleconomics said:
Yeah that confused me as well - I don't quite understand how this is being tabulated (yet), I haven't dug into their methods.
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Mandelin Rain said:
But yes, if 763 people applied this year, forget about a market driven solution to overtraining.
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I'm trying to figure out if this data shows 763 human beings applied to rad onc this year. If so WE'RE BACK BABY.

Anybody else notice "Radiation-Diagnostic" as a specialty. Better that than radiology oncology!
 
thecarbonionangle said:
ive seen journals which anonymize all and some that show you the full list of authors. The other issue is anonymity is not what it seems. The internet and subtle clues eventually allow you to find out who some people are if you try. Some people are not as anonymous as they think!
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Tread lightly and carry a big stick
 
jondunn said:
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Spratt is such an anomaly in Radiation Oncology.

Many of his clinical opinions on Twitter and MedNet (and his publications) are clear and to the point.

Does he...has he ever heard the rest of the academicians? Doesn't he want to wax poetic about how diurnal weather patterns and the strength of the solar wind may influence p53 activation in Luminal B, not Luminal A breast cancer?
 
He has tons of biases it’s funny that he thinks he doesnt

He’s incredibly lacking in self awareness
 
elementaryschooleconomics said:
Spratt is such an anomaly in Radiation Oncology.

Many of his clinical opinions on Twitter and MedNet (and his publications) are clear and to the point.

Does he...has he ever heard the rest of the academicians? Doesn't he want to wax poetic about how diurnal weather patterns and the strength of the solar wind may influence p53 activation in Luminal B, not Luminal A breast cancer?
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I don't agree with everything, but he is on point with most his stuff (well I disagree with him here on STAMPEDE though...). His opinions are definitely better than most and I definitely listen when he speaks on clinical stuff. Can't take that away from him.
 
elementaryschooleconomics said:
Spratt is such an anomaly in Radiation Oncology.

Many of his clinical opinions on Twitter and MedNet (and his publications) are clear and to the point.

Does he...has he ever heard the rest of the academicians? Doesn't he want to wax poetic about how diurnal weather patterns and the strength of the solar wind may influence p53 activation in Luminal B, not Luminal A breast cancer?
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His MedNet answers are what textbooks should read like. Twitter interactions - he comes off like a bully. Happens so often - his point is sound, but the tone and pugilism make it unpleasant. Maybe same can be said for me …
 
RealSimulD said:
His MedNet answers are what textbooks should read like. Twitter interactions - he comes off like a bully. Happens so often - his point is sound, but the tone and pugilism make it unpleasant. Maybe same can be said for me …
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Completely agree (except I don't think you come across as a bully...?).

We all have personality quirks, I guess. I can see a point in the future where I have all his MedNet posts saved in a PDF yet have him muted on Twitter...
 
elementaryschooleconomics said:
Completely agree (except I don't think you come across as a bully...?).

We all have personality quirks, I guess. I can see a point in the future where I have all his MedNet posts saved in a PDF yet have him muted on Twitter...
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I think I have grown to like Dan’s approach on Twitter. Kind of like “The Angry Young Man” by Billy Joel. His tack will be different 10 years from now if for no other reason that it must be exhausting being so right.
 
RealSimulD said:
His MedNet answers are what textbooks should read like. Twitter interactions - he comes off like a bully. Happens so often - his point is sound, but the tone and pugilism make it unpleasant. Maybe same can be said for me …
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I think what all of us into trouble from time to time is talking in absolutes, especially there are multiple reasonable ways to approach a clinical question. I know it took me some time to adjust to phrasing things respectfully in tumor board.
 
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