Rad Onc Twitter

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RadsWFA1900 said:
It really doesn’t have anything to do with radiation oncology other than the fact that she is a rad onc. If I was even tangentially involved in something like this where the plane was forced to land, I don’t think I would want to draw attn to it at all no matter if I was in the right or not.
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Agree, seems irrelevant to the spirit of this thread imo @jondunn
 
jondunn said:
Spratt is gonna be PISSED when he matches a guy who eats ketchup!

can you imagine the faculty meeting? I wouldn't want to sit in throwing distance of Chairman Dan
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It's gonna be really awkward in the situation room when the options in the SOAP are either a guy who eats ketchup, or a guy who eats ACTUAL soap.
 
I’ve never seen a specialty talk so often about how great their candidates are. What unusual times. It must be a response to the idea that the candidates being “different” than those of 5 years ago. I only blame the PDs and chairs that equates quality with board scores, publication, American MD degre and pedigree. I’m sure we will see more people talk about how great their interviewees are before Match. Bizarre. As part of the faculty of the local DO school, I’m embarrassed at how the field excluded them. The ones interested are telling me “I don’t have the scores” … perception still exists.
 
RealSimulD said:
I’ve never seen a specialty talk so often about how great their candidates are. What unusual times. It must be a response to the idea that the candidates being “different” than those of 5 years ago. I only blame the PDs and chairs that equates quality with board scores, publication, American MD degre and pedigree. I’m sure we will see more people talk about how great their interviewees are before Match. Bizarre. As part of the faculty of the local DO school, I’m embarrassed at how the field excluded them. The ones interested are telling me “I don’t have the scores” … perception still exists.
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They probably just don't want to acknowledge how ****ty the candidates were decades ago back in the pre IMRT days and how things have been coming full circle?
 
metallica81788 said:
Nobody ever talked about how amazing my group of candidates were from ~2012-2016 when you had to be superhuman just to match anywhere
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Yeah! I'm sure I have versions of my ERAS stuff from back then, can I send it to Ralph so he can Tweet my headshot with a hashtag like, perhaps not "TBT" or "ThrowBackThursday" but maybe..."RAR" or "RetroactiveRockstar"?
 
jondunn said:
why should she not? I really don't get the question.
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Question is, why is this on Rad Onc Twitter? What does this have to do with Rad Onc? The poster is a Rad Onc, so posting all aspects of personal life, that have zero to do with anything Rad Onc related as a subject, are fair game to post here? Is that what we're going for? Is that your goal JD? Is that the dream? Everyone posting about Rad Oncs doing Peloton, being on a plane, posting pics of their kids, posting about their families, posting about COVID, posting about anything and everything NOT related to the field of radiation oncology, with no care of filters. That's twitter. But you, you want to bring that to Rad Onc twitter... and did you? Sure. And what am I going to do about it? At this point? Not a damn thing. Because this thread has gone on for 177 pages of mostly unfiltered sewage, and will likely go on for another 177 pages minimum. And the sewage will grow, will grow at exponential rate as all others start posting about a Rad Onc doing non rad-onc things, and then eventually NON-rad oncs doing NON-rad onc things, and then this will just turn into the first page of reddit, except no up or down votes. Only up votes. Everything visible. Just one giant steaming pile of unfiltered sewage. That's what this thread will boil into. And JD, you aren't the only one to blame, but you might be the most critical piece of it. Unfiltered sewage could just stay on twitter and I could avoid following all these people I don't care about. But I can't do that now, not when you post it here. Forcing me to read Unfiltered Sewage time after time about things that have one slight piece of fabric as being related to Rad Onc. And eventually thread will break and the unfiltered sewage will flow like an abyss for all time. Eventually, time will come, and yet there will be someone to persevere on and post in Rad Onc twitter, even as society collapses and the Heat Death of the Universe approaches.

The above has no criticism of Dr. Winkfield - her original tweet was likely not meant to go as viral as it did in a moment of emotional frustration , and her thread afterwards is... actually super reasonable. Very Un-Karen.
 
evilbooyaa said:
Question is, why is this on Rad Onc Twitter? What does this have to do with Rad Onc? The poster is a Rad Onc, so posting all aspects of personal life, that have zero to do with anything Rad Onc related as a subject, are fair game to post here? Is that what we're going for? Is that your goal JD? Is that the dream? Everyone posting about Rad Oncs doing Peloton, being on a plane, posting pics of their kids, posting about their families, posting about COVID, posting about anything and everything NOT related to the field of radiation oncology, with no care of filters. That's twitter. But you, you want to bring that to Rad Onc twitter... and did you? Sure. And what am I going to do about it? At this point? Not a damn thing. Because this thread has gone on for 177 pages of mostly unfiltered sewage, and will likely go on for another 177 pages minimum. And the sewage will grow, will grow at exponential rate as all others start posting about a Rad Onc doing non rad-onc things, and then eventually NON-rad oncs doing NON-rad onc things, and then this will just turn into the first page of reddit, except no up or down votes. Only up votes. Everything visible. Just one giant steaming pile of unfiltered sewage. That's what this thread will boil into. And JD, you aren't the only one to blame, but you might be the most critical piece of it. Unfiltered sewage could just stay on twitter and I could avoid following all these people I don't care about. But I can't do that now, not when you post it here. Forcing me to read Unfiltered Sewage time after time about things that have one slight piece of fabric as being related to Rad Onc. And eventually thread will break and the unfiltered sewage will flow like an abyss for all time. Eventually, time will come, and yet there will be someone to persevere on and post in Rad Onc twitter, even as society collapses and the Heat Death of the Universe approaches.

The above has no criticism of Dr. Winkfield - her original tweet was likely not meant to go as viral as it did in a moment of emotional frustration , and her thread afterwards is... actually super reasonable. Very Un-Karen.
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My gesture to you friend…
 

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evilbooyaa said:
Question is, why is this on Rad Onc Twitter? What does this have to do with Rad Onc? The poster is a Rad Onc, so posting all aspects of personal life, that have zero to do with anything Rad Onc related as a subject, are fair game to post here? Is that what we're going for? Is that your goal JD? Is that the dream? Everyone posting about Rad Oncs doing Peloton, being on a plane, posting pics of their kids, posting about their families, posting about COVID, posting about anything and everything NOT related to the field of radiation oncology, with no care of filters. That's twitter. But you, you want to bring that to Rad Onc twitter... and did you? Sure. And what am I going to do about it? At this point? Not a damn thing. Because this thread has gone on for 177 pages of mostly unfiltered sewage, and will likely go on for another 177 pages minimum. And the sewage will grow, will grow at exponential rate as all others start posting about a Rad Onc doing non rad-onc things, and then eventually NON-rad oncs doing NON-rad onc things, and then this will just turn into the first page of reddit, except no up or down votes. Only up votes. Everything visible. Just one giant steaming pile of unfiltered sewage. That's what this thread will boil into. And JD, you aren't the only one to blame, but you might be the most critical piece of it. Unfiltered sewage could just stay on twitter and I could avoid following all these people I don't care about. But I can't do that now, not when you post it here. Forcing me to read Unfiltered Sewage time after time about things that have one slight piece of fabric as being related to Rad Onc. And eventually thread will break and the unfiltered sewage will flow like an abyss for all time. Eventually, time will come, and yet there will be someone to persevere on and post in Rad Onc twitter, even as society collapses and the Heat Death of the Universe approaches.

The above has no criticism of Dr. Winkfield - her original tweet was likely not meant to go as viral as it did in a moment of emotional frustration , and her thread afterwards is... actually super reasonable. Very Un-Karen.
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Gator has been saying this for a while about JD’s contributions to the thread. You just said it more loudly and funnier.
 
Does anybody have a complete list of programs that have cut down in the last few years? I thought it used to exist on SDN somewhere
 
Tsigolonco noitaidar said:
Definitely all 13 CC physician faculty should pat themselves on the back for this terrible hardship they are taking upon themselves. They now have to run their own service 6 days out of the entire year.
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Yeah…..I know you thought you were being smart, but Cleveland clinic isn’t the one to point to. They already have multiple faculty uncovered at any time, including the chairman a few months a year.
 
Tsigolonco noitaidar said:
Definitely all 13 CC physician faculty should pat themselves on the back for this terrible hardship they are taking upon themselves. They now have to run their own service 6 days out of the entire year.
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?? Spoken like a true person who has no knowledge of the CCF system. Having an attending be uncovered was... like already a thing up there.

Don't hate em cause you ain't em.
 
jondunn said:
Yeah…..I know you thought you were being smart, but Cleveland clinic isn’t the one to point to. They already have multiple faculty uncovered at any time, including the chairman a few months a year.
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Ahh you’re right, it was a joke in poor taste and improperly maligned the CCF people. Unintentional!
 
As someone who studies political discourse, I am concerned that the wording is "plans to reduce". That creates wiggle room because the reduction could be in 2030 as opposed to "we normally match 3 and in this upcoming 2022 match, we will only match 1".
 
theradiator said:
As someone who studies political discourse, I am concerned that the wording is "plans to reduce". That creates wiggle room because the reduction could be in 2030 as opposed to "we normally match 3 and in this upcoming 2022 match, we will only match 1".
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Yeah and OPEC also has “plans to increase oil production”
 
theradiator said:
As someone who studies political discourse, I am concerned that the wording is "plans to reduce". That creates wiggle room because the reduction could be in 2030 as opposed to "we normally match 3 and in this upcoming 2022 match, we will only match 1".
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I think this screencap tweet was meant to show what was in their NRMP screen (normally match 4, this year 2, and no SOAP). Worth reading the whole Twitter thread

 
Call me an idealist, but I'm hopeful that as this field trends younger and the proportion of academic attendings that trained with modern EMRs/treatment planning techniques increases, the benefits and thus necessity of resident coverage will diminish. This would push residents onto services with attendings that actually have an interest in teaching rather than those that just need a scut monkey to complete their work. I do think things are moving in this direction as this is becoming the norm rather than the exception.

1-2 spots may not make a difference in the grand scheme of things, but it's a start and you have to start somewhere. Kudos to Rahul for making the change and putting his money where his mouth is. I think that CC is a fantastic training program and I'd much rather see the fat trimmed from the bottom, but hopefully this will continue to put pressure on top programs to follow suit which could potentially start to trickle down.
 
RSAOaky said:
Call me an idealist, but I'm hopeful that as this field trends younger and the proportion of academic attendings that trained with modern EMRs/treatment planning techniques increases, the benefits and thus necessity of resident coverage will diminish. This would push residents onto services with attendings that actually have an interest in teaching rather than those that just need a scut monkey to complete their work. I do think things are moving in this direction as this is becoming the norm rather than the exception.

1-2 spots may not make a difference in the grand scheme of things, but it's a start and you have to start somewhere. Kudos to Rahul for making the change and putting his money where his mouth is. I think that CC is a fantastic training program and I'd much rather see the fat trimmed from the bottom, but hopefully this will continue to put pressure on top programs to follow suit which could potentially start to trickle down.
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I share your optimism in principle but I wonder what is possibly going to make a hellpit cut their own leg off? these places literally need residents. Its not like shaming them has worked in the past. The truth is all these places think their program is fantastic. Columbia is expanding. PD came on here and justified it in similar terms. Everyone thinks their experience is great.
The only way to fix this is to close programs by force. Everyone knows the bottom quartile. Some of these places have been around since 1980s and they still bad. How much time do they need to improve? It clearly has never been a goal and a focus at these places and reflects severe issues at the institution or programs. We know the answer folks and what needs to be done.
 
thecarbonionangle said:
I share your optimism in principle but I wonder what is possibly going to make a hellpit cut their own leg off? these places literally need residents. Its not like shaming them has worked in the past. The truth is all these places think their program is fantastic. Columbia is expanding. PD came on here and justified it in similar terms. Everyone thinks their experience is great.
The only way to fix this is to close programs by force. Everyone knows the bottom quartile. Some of these places have been around since 1980s and they still bad. How much time do they need to improve? It clearly has never been a goal and a focus at these places and reflects severe issues at the institution or programs. We know the answer folks and what needs to be done.
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This!
 
thecarbonionangle said:
I share your optimism in principle but I wonder what is possibly going to make a hellpit cut their own leg off? these places literally need residents. Its not like shaming them has worked in the past. The truth is all these places think their program is fantastic. Columbia is expanding. PD came on here and justified it in similar terms. Everyone thinks their experience is great.
The only way to fix this is to close programs by force. Everyone knows the bottom quartile. Some of these places have been around since 1980s and they still bad. How much time do they need to improve? It clearly has never been a goal and a focus at these places and reflects severe issues at the institution or programs. We know the answer folks and what needs to be done.
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Who is going to hire residents from **** programs? Honest
 
RadsWFA1900 said:
Exactly. With a pipeline of idiots from top programs who just figured out that nobody cares about your retrospective data or even pedigree. Its all supply and demand.
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Yip. Would also be concerned about hiring candidates from top programs as I would have my doubts about their judgement.
 
medgator said:
Who is going to hire residents from **** programs? Honest
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Reality is that with increasing consolidation in the medical world physicians are increasingly viewed as interchangeable widgets by the management that hires. So long as you have a medical license and board certification they will opt for whomever they can get for the cheapest without consideration of pedigree.
 
RickyScott said:
Yip. Would also be concerned about hiring candidates from top programs as I would have my doubts about their judgement.
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The problem with them is basically everything

We are still getting the overachievers from peak RO…i cannot even talk to them because it’s like speaking a totally different language

No idea how billing works, no idea how to get along with referring, quick to correct you on some study minutiae they read like that impresses me or anybody else. And they’ll literally work for 200K and nod and say yes…not really colleagues I want to work with
 
RadsWFA1900 said:
The problem with them is basically everything

We are still getting the overachievers from peak RO…i cannot even talk to them because it’s like speaking a totally different language

No idea how billing works, no idea how to get along with referring, quick to correct you on some study minutiae they read like that impresses me or anybody else. And they’ll literally work for 200K and nod and say yes…not really colleagues I want to work with
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Servitude is deeply instilled into people’s psyche at the ivory towers. If all you have known is being a butt kisser, thats what you see as normal.
 
fiji128 said:
Reality is that with increasing consolidation in the medical world physicians are increasingly viewed as interchangeable widgets by the management that hires. So long as you have a medical license and board certification they will opt for whomever they can get for the cheapest without consideration of pedigree.
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I’m sure they’ve been sufficiently brain washed at this point to think all they have to do is try harder and be better…oh those poor souls
 
thecarbonionangle said:
I share your optimism in principle but I wonder what is possibly going to make a hellpit cut their own leg off? these places literally need residents. Its not like shaming them has worked in the past. The truth is all these places think their program is fantastic. Columbia is expanding. PD came on here and justified it in similar terms. Everyone thinks their experience is great.
The only way to fix this is to close programs by force. Everyone knows the bottom quartile. Some of these places have been around since 1980s and they still bad. How much time do they need to improve? It clearly has never been a goal and a focus at these places and reflects severe issues at the institution or programs. We know the answer folks and what needs to be done.
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I like to believe that if we exist in a world where our leaders show leadership, others will eventually follow suit. I've railed on the powers that be in our field for not cutting spots and so I similarly must give credit where credit is due. Rahul and CC are cutting positions, which does nothing but hurt them as a program. I am glad there will be fewer radoncs trained, and I hope that as others show similar leadership and follow suit in the coming years we begin to ask ourselves and one another "why are we losing Cleveland Clinic trained physicians while Loma Linda and University of Mississippi continue to exist as training programs."

To be a pessimist I don't think these changes will happen quickly enough to stave off the impending collapse of the job market. Those that point to the job market for new graduates as being "strong" are delusional. It's a game of musical chairs and eventually these grads will get caught without a seat. We're going through an era of suburban expansion by big radonc that won't last forever. Big academic centers are either buying out smaller hospitals/clinics and pushing out older physicians or opening up new satellites right next door. We've all heard this story again and again.

Those that graduated a couple years ago at 300-350k are now experienced physicians. They realize that when they asked about salary outlook a few years down the line and were told "that's negotiable" what it really meant was "you might get an extra 10-30k every few years if we really like you." They realize their only upward mobility is to leave to become the medical director at some new satellite or recently bought clinic where they will make 350-400k with more administrative responsibilities, whereas the old docs being pushed out were making 500-600k+. New grads fill the vacant role that was left behind and the game of musical chairs continues.

Eventually it doesn't make sense to expand anymore. This may be because of reimbursement cuts (RO-APM), it may be because there's nowhere left to expand as "suburban expansion" becomes "rural expansion," it may be that big health from 'City X' is now in the territory of 'City Y' and the financials of running a barebones doc in the box no longer make sense. When it happens, it will likely be some combination of these factors. It won't happen this year, it may not happen a few years from now, but the average age of radonc is only going down, and the thousands of graduates we've trained over the last decade are going to need jobs for a very long time. Sooner or later someone's going to be left holding the bag.

I speak to new grads occasionally who talk a big game about the job market being robust and them having multiple good offers, but then I see them moving somewhere else a few years down the line. The health of the job market has never really been about your first job. New graduates are better trained and more competent than ever, and frankly their pay has increased relatively little as their value has increased dramatically. The health of the job market is about your second or third job, the one you hope to spend the rest of your career at. Those are the ones that have been getting less rewarding and more commoditized over time. It's only a matter of time before the music stops.
 
RSAOaky said:
I like to believe that if we exist in a world where our leaders show leadership, others will eventually follow suit. I've railed on the powers that be in our field for not cutting spots and so I similarly must give credit where credit is due. Rahul and CC are cutting positions, which does nothing but hurt them as a program. I am glad there will be fewer radoncs trained, and I hope that as others show similar leadership and follow suit in the coming years we begin to ask ourselves and one another "why are we losing Cleveland Clinic trained physicians while Loma Linda and University of Mississippi continue to exist as training programs."

To be a pessimist I don't think these changes will happen quickly enough to stave off the impending collapse of the job market. Those that point to the job market for new graduates as being "strong" are delusional. It's a game of musical chairs and eventually these grads will get caught without a seat. We're going through an era of suburban expansion by big radonc that won't last forever. Big academic centers are either buying out smaller hospitals/clinics and pushing out older physicians or opening up new satellites right next door. We've all heard this story again and again.

Those that graduated a couple years ago at 300-350k are now experienced physicians. They realize that when they asked about salary outlook a few years down the line and were told "that's negotiable" what it really meant was "you might get an extra 10-30k every few years if we really like you." They realize their only upward mobility is to leave to become the medical director at some new satellite or recently bought clinic where they will make 350-400k with more administrative responsibilities, whereas the old docs being pushed out were making 500-600k+. New grads fill the vacant role that was left behind and the game of musical chairs continues.

Eventually it doesn't make sense to expand anymore. This may be because of reimbursement cuts (RO-APM), it may be because there's nowhere left to expand as "suburban expansion" becomes "rural expansion," it may be that big health from 'City X' is now in the territory of 'City Y' and the financials of running a barebones doc in the box no longer make sense. When it happens, it will likely be some combination of these factors. It won't happen this year, it may not happen a few years from now, but the average age of radonc is only going down, and the thousands of graduates we've trained over the last decade are going to need jobs for a very long time. Sooner or later someone's going to be left holding the bag.

I speak to new grads occasionally who talk a big game about the job market being robust and them having multiple good offers, but then I see them moving somewhere else a few years down the line. The health of the job market has never really been about your first job. New graduates are better trained and more competent than ever, and frankly their pay has increased relatively little as their value has increased dramatically. The health of the job market is about your second or third job, the one you hope to spend the rest of your career at. Those are the ones that have been getting less rewarding and more commoditized over time. It's only a matter of time before the music stops.
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This is a perfect summary - until and unless the SCAROP crew can provide me with any sort of counter-argument to these points, I will continue to roll my eyes at the ARRO survey or "people hearing" about the job offers this year.

If I turn on the Weather Channel right now, I can see some snow storms in the forecast for some parts of the country. I don't then think, "thank God we fixed climate change".
 
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