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Does st Jude’s have protons?
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if they don't I know they're about to
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Probably more useful there than a second or third center in any major Sunbelt City
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looks like they do.rickyscott said:
Proton Therapy Center
St. Jude is home to the world’s first proton beam therapy center just for children. Learn why St. Jude is a leader in radiation oncology for childhood cancer.
www.stjude.org
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Obviously, the math is really difficult to nail down on this, but lest we ever forget the real reason there are still people denying an oversupply issue:
I would say that, given the reimbursement RadOnc generates, we're much closer to the Cardiology Fellow estimate than the other specialties.
If I were that hole-in-the-wall NYC program, I'd open a residency program, too.
I would say that, given the reimbursement RadOnc generates, we're much closer to the Cardiology Fellow estimate than the other specialties.
If I were that hole-in-the-wall NYC program, I'd open a residency program, too.
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The attempted Hahnemann auctions set the floor for resident value: $100,000 / year.
Hahnemann residency programs draw winning bid of $55M from local health systems
A group of six local health systems outbid Reading-based Tower Health for the residency slots that had been assigned to Hahnemann University Hospital.
whyy.org
Of course, you could also look at how many midlevels UNM had to hire to replace their 10 neurosurgery residents when their residency shut down: 23
The Resident to Midlevel Ratio | Ben White
As a great bookend to my recent brief article about resident pay, here’s an interesting little data point from this article about the shutdown of UNM’s neurosurgery residency for ACGME violations: In the immediate future, UNM plans to double the number of neurosurgeons on staff by March. They...
www.benwhite.com
This notion that residents are a cost center is a Boomer gaslighting fantasy. The alternative is that these places will hire midlevels. And now HCA is hell bent on opening as many residencies as possible to reduce their long term physician labor costs (and possibly reduce their dependence on midlevels)
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This. The kind of abuse that can be heaped on residents would cost a hell of a lot to outsource to an attending.The attempted Hahnemann auctions set the floor for resident value: $100,000 / year.
Hahnemann residency programs draw winning bid of $55M from local health systems
A group of six local health systems outbid Reading-based Tower Health for the residency slots that had been assigned to Hahnemann University Hospital.
Of course, you could also look at how many midlevels UNM had to hire to replace their 10 neurosurgery residents when their residency shut down: 23
The Resident to Midlevel Ratio | Ben White
As a great bookend to my recent brief article about resident pay, here’s an interesting little data point from this article about the shutdown of UNM’s neurosurgery residency for ACGME violations: In the immediate future, UNM plans to double the number of neurosurgeons on staff by March. They...
This notion that residents are a cost center is a Boomer gaslighting fantasy. The alternative is that these places will hire midlevels. And now HCA is hell bent on opening as many residencies as possible to reduce their long term physician labor costs (and possibly reduce their dependence on midlevels)
Our junior residents covered primary night call at 6 major hospitals. Going rate for a smaller community hospital to buy urology coverage for ER/floor is 500-1500/day. To get an attending to cover what we did would be minimum 5k/night.
What happened to Hahnemann spots at the end? I though sale was blocked and positions just evaporatedThe attempted Hahnemann auctions set the floor for resident value: $100,000 / year.
Hahnemann residency programs draw winning bid of $55M from local health systems
A group of six local health systems outbid Reading-based Tower Health for the residency slots that had been assigned to Hahnemann University Hospital.
Of course, you could also look at how many midlevels UNM had to hire to replace their 10 neurosurgery residents when their residency shut down: 23
The Resident to Midlevel Ratio | Ben White
As a great bookend to my recent brief article about resident pay, here’s an interesting little data point from this article about the shutdown of UNM’s neurosurgery residency for ACGME violations: In the immediate future, UNM plans to double the number of neurosurgeons on staff by March. They...
This notion that residents are a cost center is a Boomer gaslighting fantasy. The alternative is that these places will hire midlevels. And now HCA is hell bent on opening as many residencies as possible to reduce their long term physician labor costs (and possibly reduce their dependence on midlevels)
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Yeah the idea of trying to “sell” CME funded resident spots was pretty ridiculous. It would be like auctioning off your RO1. If it isn’t illegal, it should be.
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The rad onc residents were not reassigned and had to scramble on their own... I should be more specific: the matched-but-not-started residents were not reassigned.
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tick, tick, boom?
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I know for a fact some of those places are looking.... Just not for a new grad. That's correct. Heck Baptist in Jax has been reposting that job a few timestick, tick, boom?
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lol
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The Genesis Twitter account responded:
When I was throwing everything at the wall to see what stuck during PGY5, I cold-emailed their recruiter(s) a couple of times (I can't remember if it was this person or not). I never heard back.
Excellent advice, person managing this Twitter account.
(eventually I networked my way to a phone number of a medical director in a geographic area I was interested in but pursued other avenues instead)
(just gotta pull yourself up by your bootstraps)
When I was throwing everything at the wall to see what stuck during PGY5, I cold-emailed their recruiter(s) a couple of times (I can't remember if it was this person or not). I never heard back.
Excellent advice, person managing this Twitter account.
(eventually I networked my way to a phone number of a medical director in a geographic area I was interested in but pursued other avenues instead)
(just gotta pull yourself up by your bootstraps)
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Things older men should never say about women, no matter the context:
[x] Gotta catch 'em young
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D
deleted941485
The attempted Hahnemann auctions set the floor for resident value: $100,000 / year.
Hahnemann residency programs draw winning bid of $55M from local health systems
A group of six local health systems outbid Reading-based Tower Health for the residency slots that had been assigned to Hahnemann University Hospital.
Of course, you could also look at how many midlevels UNM had to hire to replace their 10 neurosurgery residents when their residency shut down: 23
The Resident to Midlevel Ratio | Ben White
As a great bookend to my recent brief article about resident pay, here’s an interesting little data point from this article about the shutdown of UNM’s neurosurgery residency for ACGME violations: In the immediate future, UNM plans to double the number of neurosurgeons on staff by March. They...
This notion that residents are a cost center is a Boomer gaslighting fantasy. The alternative is that these places will hire midlevels. And now HCA is hell bent on opening as many residencies as possible to reduce their long term physician labor costs (and possibly reduce their dependence on midlevels)
Honestly they know when they get a resident they are getting the like 2x the work a a regular employee. The idea that CMS still funds a substantial number of slots I think is a bit ridiculous. Considering how many hospitals operate like this.
The long game is great for big hospital chains. Work the residents hard and make money and then when they get out you can low ball them when they are attendings.
I find this laughable.
Somehow, our specialty gets elevated to "small decision = severe toxicity or death".
I have seen tons of stuff in my life (as you all do). Small "decision" by Thoracic surgeon, pt died. Small "decision" by neurosurgeon, pt paralyzed.
Small "decision" by gensurg, had anastomotic leak. Medonc small "decision", pt died...
That is not the justification for oral exam.
The way forward is to attract best trainees and elevate quality of programs and get rid of sh*tty programs.
A quality program is one that graduates a candidate safe for independent practice, even w/o taking/passing the ABR exam.
Passing the ABR exam has very little bearing on one's competency.
OTOH, failing the ABR has some more to do with competency.
Somehow, our specialty gets elevated to "small decision = severe toxicity or death".
I have seen tons of stuff in my life (as you all do). Small "decision" by Thoracic surgeon, pt died. Small "decision" by neurosurgeon, pt paralyzed.
Small "decision" by gensurg, had anastomotic leak. Medonc small "decision", pt died...
That is not the justification for oral exam.
The way forward is to attract best trainees and elevate quality of programs and get rid of sh*tty programs.
A quality program is one that graduates a candidate safe for independent practice, even w/o taking/passing the ABR exam.
Passing the ABR exam has very little bearing on one's competency.
OTOH, failing the ABR has some more to do with competency.
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In theory, if a residency program has its primary mission of properly training its trainees for better-than-average competency—and never fails in its mission—an oral exam of trainees would be moot. And would certainly not prevent mistakes by trainees forward in time. What would then be better, if we follow logic, is to give oral exams to the educators in residency programs to prevent their mistakes forward in time.
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I find it interesting to see these two Twitter posts juxtapose to each other.
On the one hand, you have one person who chose our specialty years ago, having a difficult time finding a job in the second and third most populous state in America, with the only advice is to talk to some physician recruiter with an oncology conglomerate. And on the other hand, you have multiple responses to a Twitter post (creepy AF comments), begging a medical student to choose radiation oncology.
This paper came out earlier this morning, showing that the employment outcomes for Canadian grads have improved after "national corrective measures to regulate resident intake in 2011 appear to have had a positive impact on the employment outcomes of recent Canadian RO graduates."
Employment Outcomes for Canadian Radiation Oncology Graduates: 2020 Assessment and Longitudinal Trends
We have a long way to go, as frequently discussed here, before we should be begging students to choose radiation oncology (and do it in a non-sleazy way). Come join us, but you have nowhere to go. Choose wisely.
On the one hand, you have one person who chose our specialty years ago, having a difficult time finding a job in the second and third most populous state in America, with the only advice is to talk to some physician recruiter with an oncology conglomerate. And on the other hand, you have multiple responses to a Twitter post (creepy AF comments), begging a medical student to choose radiation oncology.
This paper came out earlier this morning, showing that the employment outcomes for Canadian grads have improved after "national corrective measures to regulate resident intake in 2011 appear to have had a positive impact on the employment outcomes of recent Canadian RO graduates."
Employment Outcomes for Canadian Radiation Oncology Graduates: 2020 Assessment and Longitudinal Trends
We have a long way to go, as frequently discussed here, before we should be begging students to choose radiation oncology (and do it in a non-sleazy way). Come join us, but you have nowhere to go. Choose wisely.
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Also, why does Sean Collins always capitalize the first letter in every word? It's weird!
Talking about passing ABR exam, or any post-grad exam (whether one is internist, surgeon etc.)...
I have seen many specialists passing their respective board exams, but then "enjoy their life and do very little reading" for the next 30-40 years.
OTOH, I have seen fantastic MDs that keep up with lit and are "up there".
The hallmark of a good physician is not about passing the board exam, it is how to keep up with lit and practice guidelines for the next 30-40 years.
Very much like a runner who jogs everyday to keep in shape or a professional pianist practising everyday to keep up before a concert.
If we can only learn from the athletes and professional musicians...
I have seen many specialists passing their respective board exams, but then "enjoy their life and do very little reading" for the next 30-40 years.
OTOH, I have seen fantastic MDs that keep up with lit and are "up there".
The hallmark of a good physician is not about passing the board exam, it is how to keep up with lit and practice guidelines for the next 30-40 years.
Very much like a runner who jogs everyday to keep in shape or a professional pianist practising everyday to keep up before a concert.
If we can only learn from the athletes and professional musicians...
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Someone please please give some insight. I’ve wondered the exact same thing
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This touched a nerve
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I would say under the current era of program expansion and places like LIJ, Columbia, Methodist, Mississippi etc literally training anyone they can match, until you cull these hellpits, the oral exam should stick around.
As quite a few of us stated, it was a royal PITA to prepare but we all felt like it made us better Rad Oncs, certainly better than the writtens or anything else
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Yes, we should send our best and brightest to a field where you send the tumor off for molecular tests and give whatever the algorithm says. The future is bright for molecular medicine, no doubt, but seems pretty boring. I suppose there's job stability, but if you really think about how medical oncology works now, and moreso in the future, they seem way more replaceable in general. Presuming our modality isn't eliminated entire of course.
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Exactly.
I once had a RadOnc tell me they learned "all [they] needed to know 20 years ago" and have practiced the same way ever since. This person was only somewhat joking. While very few people say something like that aloud, we all know docs who fall into this category. Sometimes, we know many docs in this category.
The ABR has functionally created one of the strangest board certification systems in American medicine. I have spent a lot of time trying to figure out how we got here:
This paper from 1986 helps explain the evolution...and stagnation:
As near as I can tell from this, having written exams in radbio/physics/clinical was "born" in 1974 or 1975. I believe certification in RadOnc prior to this (starting in the 1930s) was only an oral exam. Those were the good old days - where you could get a certificate in "Roentgenology" or "Therapeutic Roentgenology".
But, the "modern" playbook for board certification in Radiation Oncology is from almost a half century ago.
Alright, so clearly we perfected board certification, right?
Sort of. The ABR decided in 1995 that they would no longer issue "lifetime" certification, and they jumped aboard the MOC Money Train™.
I'll skip over what MOC was initially, because now we have OLA. Compared to initial certification, the OLA questions seem to lack a certain...rigor. If anyone would like to debate that point, I would really like to hear it.
Putting everything together:
1) Our 4 exam system was created in ~1975 and has not been comprehensively changed since then (no, changing when people can take the written exams or developing the virtual platform do not count). To my knowledge, we remain the only specialty with 4 exams, as well as the only ones with basic science exams.
2) Practicing today, in 2022, we have physicians on a lifetime certificate who haven't been asked to demonstrate their knowledge in almost 30 years. We also have physicians practicing with continuous certificates who participate in OLA, with the questions significantly "easier" than the initial certification process. The gap in difficulty either indicates the initial certification process is more "hazing" than certifying minimal competence (suggested by the Amdur/Lee paper about increasing average Step 1 scores with unchanged board pass rates) or a blatant money grab by the ABR (if too many people fail and lose certification status, they can't pay for their OLA subscription). Perhaps both are true.
3) KO's assertion about us being an "invasive" specialty therefore we NEED oral boards is a common trope and obviously false. The specialties where potentially life and death decisions must be made quickly (surgeons, Emergency Medicine, etc) - those are where oral boards make some semblance of sense. Remember a couple months ago when there was the Twitter thread talking about how we don't get "scheduled contouring time"?
The majority of us don't get protected time for contouring. Would surgeons EVER be asked to do that? Just squeeze in some surgery during lunch or at 10PM after the kids are in bed?
I would argue this is the litmus test for if something is invasive/requiring split-second decisions where an oral exam is important. If contouring and treatment planning is functionally treated no differently than catching up on charting or writing emails - it is not invasive. I'm definitely NOT saying I agree with this practice - I wish we all did have blocked off time.
I don't think anyone is ever saying we shouldn't have exams - we definitely should. But the lack of attention paid to the medical education of Radiation Oncology and the board certification process itself is incredibly disappointing.
Like good little cogs in the machine, we just churn through the process because "we're supposed to", because we think there's a plan, a purpose, proof that what we're doing has merit. Changing this process would be tacitly acknowledging we didn't design the perfect system in 1975, and would harm a lot of egos living in the minds of our gray-haired sovereigns.
We can't have that, now can we?
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Be careful that you have the ABR change things for the better. The changes to Radiology's examinations have had wide-ranging effects on the training pipeline:
1. It essentially forces post-2012 trainees into fellowship as you cannot obtain board certification until 15 months post graduation from Radiology.
2. The Core + Certifying format and timing tacitly admits that you only need 3 years of training for Radiology despite being a 4 year residency.
3. It has arguably forced excessive subspecialization (which may or may not be protective for our job markets. I'm mixed on this complaint).
As a field, we should have reduced our residency to 3 years and just accepted that fellowship is required. At least the people entering fellowships would have full BE and licenses and be able to moonlight. Relentless telescoping training is good for no one (except academics who thrive off cheap labor).
Do you trust the ABR to not institute a similar thing for you guys? Where you suddenly de-facto force fellowships or disease-site specialization vs generalist Radoncs as community practice is currently?
I agree that your # of exams (and content of the Radbio exam) are crazy. We used to have a separate written for AU status which got merged into our Core exam; of course it's tested in the most obnoxious way. The same content is somehow sanely tested by the ABNM (as I took both exams and WILL NOT take the ABR Nuc Rad CAQ).
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I am also wary about some of the discussed changes on that thread - like the person saying a standardized patient would be a good idea. I already did OSCEs and Step 2 CS. I don't need to do that again.
the best change they made was making it virtual. i had to take it in Kentucky. waste of money and time and stress versus you all that take it in comfort of home now.
the best change they made was making it virtual. i had to take it in Kentucky. waste of money and time and stress versus you all that take it in comfort of home now.
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You both have excellent points. I definitely don't trust the ABR to do it "right", for many reasons, not the least of which is that we can never know what "right" is.
If I had a magic wand, assuming the structure of our residency is the same:
1) Everything virtual forever.
2) Single written exam taken at any point after the end of PGY3, left up to the examinee. Multiple dates of administration. 75-80% clinical, 15% physics, a stray radbio question allowed to sneak through (preferably on BED).
3) Oral exam after 1-2 years in practice. You submit 30 cases you personally treated, they select 3-5 to examine you on. An additional 2-3 sections (one general RadOnc, 1-2 either more general RadOnc or disease site specific, examinee's choice).
4) We can keep OLA as it is - those vacation homes don't buy themselves.
I don't think this is the "right" or "best" way either. I think it's an improvement in the current process. Ultimately, what matters in practice is your ability to find, evaluate, and implement information throughout your career. That's very difficult to test.
I personally know RadOncs practicing on lifetime certificates who haven't kept up. It's actually terrifying to see. Things I consider completely basic and widely known are not, in fact, widely known. The MOC system might help with this, for future generations, but it might not.
The fact remains that no one has ever demonstrated "board certification" in RadOnc (perhaps any specialty, actually) protects patients, which is allegedly the intent. Logic dictates it does - but we wouldn't accept "logic" as a justification for an NCCN treatment pathway. Why are we accepting it here?
In my dreams, especially with the COVID-induced delay in exams, we conduct a study where we take every Radiation Oncologist in America practicing over the last 12 months and examine their outcomes. This cohort would include people on lifetime certificates, people on continuous certificates, people who were board eligible and not able to sit for orals due to COVID delay, people who were board eligible and failed orals and unable to sit for retakes due to COVID delay, people who were board eligible and not able to sit for orals as per routine (class of 2021).
The current system forces the hypothesis that the continuous board-certified arm would have the "best" outcomes (safety, toxicity, efficacy). Anything other than that result would indicate the system does not function like we're expected to think it does.
If I had a magic wand, assuming the structure of our residency is the same:
1) Everything virtual forever.
2) Single written exam taken at any point after the end of PGY3, left up to the examinee. Multiple dates of administration. 75-80% clinical, 15% physics, a stray radbio question allowed to sneak through (preferably on BED).
3) Oral exam after 1-2 years in practice. You submit 30 cases you personally treated, they select 3-5 to examine you on. An additional 2-3 sections (one general RadOnc, 1-2 either more general RadOnc or disease site specific, examinee's choice).
4) We can keep OLA as it is - those vacation homes don't buy themselves.
I don't think this is the "right" or "best" way either. I think it's an improvement in the current process. Ultimately, what matters in practice is your ability to find, evaluate, and implement information throughout your career. That's very difficult to test.
I personally know RadOncs practicing on lifetime certificates who haven't kept up. It's actually terrifying to see. Things I consider completely basic and widely known are not, in fact, widely known. The MOC system might help with this, for future generations, but it might not.
The fact remains that no one has ever demonstrated "board certification" in RadOnc (perhaps any specialty, actually) protects patients, which is allegedly the intent. Logic dictates it does - but we wouldn't accept "logic" as a justification for an NCCN treatment pathway. Why are we accepting it here?
In my dreams, especially with the COVID-induced delay in exams, we conduct a study where we take every Radiation Oncologist in America practicing over the last 12 months and examine their outcomes. This cohort would include people on lifetime certificates, people on continuous certificates, people who were board eligible and not able to sit for orals due to COVID delay, people who were board eligible and failed orals and unable to sit for retakes due to COVID delay, people who were board eligible and not able to sit for orals as per routine (class of 2021).
The current system forces the hypothesis that the continuous board-certified arm would have the "best" outcomes (safety, toxicity, efficacy). Anything other than that result would indicate the system does not function like we're expected to think it does.
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"Well, you know, this is only from half the patients, but there's no way this could affect our results, so we'll just serve this data up to eviCore on a silver platter"
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Patients very often drop out from QoL assessments in trials. It's actually quite good that they managed to get more than half of the patients to fill out the forms after 5 years.
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Yeah, agreed.
It's hard not to view each new publication as insurance company ammo, though. All it takes is one paper like this for eviCore et al to set "policy" and it doesn't matter how many papers to the contrary you have or how eloquent your argument is - the individual "peer" cannot "go against policy".
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EviCore could bribe a few of these leading academics for a few thou each to make some modest non-inferiority claims and it'd be the best investment since Forrest Gump bought Apple stock.
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They'll hang their hat on that but then tell us how the 0617 secondary analysis of IMRT over 3D was unplanned and doesn't support routine use despite that being the conclusion of the paper
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There have been more randomized trials of IMRT with the word “breast” in the paper title than in any other disease subsite. The conclusion of one of the more recent trials (no subset analysis, no restrospective… this is phIII data) was: “Improved dose homogeneity with simple IMRT translates into superior overall cosmesis and reduces the risk of skin telangiectasia. These results are practice changing and should encourage centers still using two-dimensional RT to implement simple breast IMRT.” That did not stop ASTRO from 1) negating the conclusion of the paper, and 2) producing its own guideline which ostensibly said the authors of the paper improperly used the word “IMRT” throughout the the entire paper.
Evicore learned from ASTRO: truth is labile. The chickens always come home to roost.
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I don't know how medicine gets itself out of this one:
We have decided that there needs to be metrics/measurable goals to make people competitive for certain things like the Match, promotion to Associate or Full Professor, tenure, grants (R01 or other), etc
It is very hard to measure who is a good student, doctor, or scientist
It is very easy to measure number of papers published. We also built the "Impact Factor" system and now we can measure the "quality" of papers published
Humans respond to incentive; publishing papers was recognized as the primary way to advance your career, even if you never had ANY intention of staying in academia (how many private practice docs published papers as students because they had to?)
An entire industry exploded around academic publishing, eating up tax dollars - as exemplified by the recent announcement that one of the Nature journals is charging an $11,000 publishing fee for a single article
Insurance companies/benefit managers realized they could weaponize papers to justify not paying for certain procedures/techniques and hard-code it into their policy, meaning decisions cannot be reversed at the "peer" level because your average eviCore grunt doesn't have the ability to overturn policy
At each step in this process, no one feels like they're doing anything wrong, and from a certain point of view, I agree with them (except eviCore, eviCore can burn). People need to advance their career, institutions need to know who to promote and give grants to, academic publishing companies were founded decades ago and the current employees didn't design this business model but they do need to put food on the table and pay rent
Because of the money involved - this cycle seems set to continue...forever?
eviCore is the best example of this, as we all know. With enough experience, you can learn the key words/phrases to get them to "unlock" the policy and approve something - unfortunately, it's NEVER citing data for what you want to do.
Re: IMRT for breast - when do we get to talk about the sexist undertones of ASTRO's position? We're not doing that yet, right? Well, whenever people want to go there, I'm ready for it. If I had my way, using tangents would cause you to fail oral boards.
Maybe 2032 I guess.
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Publishing seems the most ripe for disruption given the explosion in online pre-prints during the pandemic. It isn’t a big stretch to imagine a platform like that where people volunteer to peer review and it becomes the definitive journal platform. Impact could be determined either by reviewer ratings of quality or based on citations/views, so academic institutions would have their metrics. It could also offer services for a nominal fee; like formatting.
Not only is this creepy af, but exploits the power imbalance between an MS3 who does not have the ability to say "please don't take a picture of me and put it on Twitter with my name" and the radonc attending who wants to do so. I would not want someone to put my picture/name on Twitter, but I have the agency in my position to say "no."
This Unfortunate Medical Student Does Not Have That Ability.
D
deleted1116990
This made me laugh. You have your work cut out for you if you think your overlords will ever allow radbio to be reduced to a single BED calc. Hell, if you said this to Paul Wallner, he might actually smack you.
There was literally a task force ~10 years ago that produced a bunch of stuff no one ever read that reinforced the hundred question monstrosity we all spent 3 years preparing for with rote memorization, guessed on half of the exam, and promptly forgot everything we didn't guess on.
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God what is up Wallner's a*s with basic science and useless minutiae. My feeling with Wallner is he's an intellectual wanna-be. He wants to pretend like he understands rad bio but 1) sorry, folks, he's a DO that entered rad onc in the early
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Totally agree - that's why I would need a magic wand.
Here's the saddest part: the majority of the research I did for my PhD was radbio. I have more experience and love for radbio than Wallner and crew would ever dream of. So, I hope that's considered when I make the following statement -
I think it's completely unnecessary to force MD-only Radiation Oncologists to take an entire exam on radiation biology.
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The emphasis on basic science, trial trivia, and recruiting md/PhD is a symptom of imposter syndrome (actually justified in this case based on who entered this field at the time). Ortho/derm/uro/optho never had this complex.
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Take a look at the chapters in the report...
Clinical Translation and Biomarkers
Signaling Pathways of Normal and Malignant Tissue
Tumor Microenvironment and Hypoxia
Radiation Sensitizers and Protectors 💩
Genomics and Epigenetics in Radiation Oncology
DNA Repair in Normal and Malignant Tissues
Tumor Metabolism
Molecular Imaging and Nanotechnology
Stem Cell Biology😵
Immunology and Inflammation
There's been 100x more progress in rad onc DEI labs than in rad onc radbio labs in the last 10y.
D
deleted1116990
Careful. If this discussion continues, the failure rate will be increased another 10% next year, and the monkeys that throw darts at the signaling pathways to figure out which will be tested will be given an extra dose of ketamine.
Seriously though, the whole exercise is so absurd it gives itself away. It's basically a ritualistic entry into the secret society of rad onc, which I would be totally cool with, if our craft were like protected and stuff.
Seriously though, the whole exercise is so absurd it gives itself away. It's basically a ritualistic entry into the secret society of rad onc, which I would be totally cool with, if our craft were like protected and stuff.
