Rad Onc Twitter

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elementaryschooleconomics said:
I like the sentiment with these proposed changes.
I have very little faith they will be enforced.

I want to be proven wrong. I want Neha and team to come back to this post and just absolutely obliterate me in the future. I hope I'm dragged all over the internet for how wrong I am.

#dreams
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What’s ironic is
1) Prostate cases are falling for residents over time
2) Whole brain?! Is this 2002?
 
TheWallnerus said:
What’s ironic is
1) Prostate cases are falling for residents over time
2) Whole brain?! Is this 2002?
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Well, in her defense - apocryphal tales from a late 2000s Penn grad imply that IMRT was "experimental"/delivered per protocol until like 2008 or something, so maybe WBRT is only recently antiquated (s/p protons).

Now, if someone who trained at Penn from that era comes and says that's NOT true, I can finally know for certain my source for this gossip is just bad at drawing circles on DICOMs and is trying to shift blame...
 
Some folks are shook

 
jondunn said:
Some folks are shook

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One of the smallest programs I know of is a program in SC. I think they will meet the 1.5:1 ratio with no changes; one resident is a special exemption from another process e.g. If there are programs smaller than this, there aren't many of them.
 
CurbYourExpectations said:
How does this work?
25% of cases can be done at other places, that is >100 cases. Or 25% of clinical time, so between 8-12 months can be spent getting cases at a distant area for disease sites your facility doesn't get enough cases for.

Also the 1.5 faculty per residents, if it includes non-primary site faculty it seems like it would be easily worked around by sending residents to more places to work with faculty who weren't teaching before or utilizing residents. If they have to be faculty at the main site they could have satellite faculty come in for one day a week and see a small amount of patients at the main hub and have residents cross cover their usual attending and this one to meet the 1.5 ratio.

This seems like if programs want to, they can make up for this in some way by making their residents lives worse.
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I’m sure at risk programs have already been forewarned and as a result already have measures in place to game the system.

There just ain’t no gaslighting and subterfuge like rad onc. Maybe path.
 
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RadsWFA1900 said:
How many times has that dude moved. Does he have a family? If I moved as much as him I’d be divorced
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Some people move like ducks to better situations but some are sitting ducks with no golden egg who end up on dinner menu. You gotta decide which one you want to be. Keep the wife happy if you are smart!
 
I'll bite.

I'm not at all embarrassed or concerned about multiple jobs in 11 years, 2 of which I left relatively quickly.

There are posters on this board that are miserable, that complain about their job, about their situation. They have a dozen excuses of why their job is ****ty or their situation is bad. The only person in control of my life is me (and my wife, now). There is no perfect. However, there are situations that are suboptimal and there are situations that are worse than that. I am halfway through my life. I have no intention of dealing with situations that, are on balance, terrible. I don't have to do it. I've saved well. I can sit around for a few years if I wanted. I could find some insurance job. I could start a business. Maybe I'll do one (or all!) of those things. I could stay in clinical medicine in a low volume job and hang out with my family a lot more and be in a situation where my kids get to see their grandparents every day if they want. And, you know what, that's what I decided. Life doesn't have to be a grind. Moving sucks, yeah. My wife isn't thrilled about it. But, you know what she's less thrilled about? Having her partner be a crappy husband and dad. She helped me come to the decision to leave. So, I think @jondunn made a funny and he's right - because my Radonc friends (including a few on this board) tease me about it. But, it's fine. I'm just not the "stay in one job for 30 years type". Maybe you are? Good for you. Even if my job was appearing to be "perfect" (and many on this board would consider my DC situation to be close to it), every job to me has an expiration date. That's who I am. But, for people out there unhappy because of their job - that's on you. You have choices. You have options. Take them. Sometimes they work out. Sometimes they don't. But, at least you took the steering wheel.
 
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RealSimulD said:
For generalist rad oncs willing to go anywhere -- You have choices. You have options. Take them. Sometimes they work out. Sometimes they don't. But, at least you took the steering wheel.
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Fixed that for you.
 
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Neuronix said:
Not being able to move anywhere is putting yourself into a box too. You are special that you've moved all over the country. I find that a lot of people are more tied down than this.
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If my parents were healthier, I’d try to live abroad.
 
Neuronix said:
Not being able to move anywhere is putting yourself into a box too. You are special that you've moved all over the country. I find that a lot of people are more tied down than this.
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a lot of people move in rad onc. more people leave than not leave.

if you stay in your post residency job forever, then you are in the minority - very much true in academics as well as PP.
 
jondunn said:
sorry this is just not true. you can leave.

i fully agree with Simul. the most annoying posts to me are the people like DukeNukem and RADSWFA who non stop talk about how horrible they have it and then do nothing to change it.
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What in the hell do you know about my life?

What an ignorant post.
 
RealSimulD said:
I'll bite.

I'm not at all embarrassed or concerned about multiple jobs in 11 years, 2 of which I left relatively quickly.
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Have you noticed problems getting desirable employers to interview you and give you serious offers? I have noticed some employers getting hung up on leaving a prior job. They always want to know about the jump, and they don't seem satisfied with my truthful answer of being recruited with promises that were not fulfilled. From my standpoint, if I am recruited with specific promises that are not fulfilled, I will leave. However, prospective employers seem to view this negatively, as if I am supposed to tolerate an employer breaching my contract and creating a situation where I am unhappy for a certain period of time because I owe them something before it becomes OK for me to leave. Logically, it would make sense that as soon as you realize there is no long-term potential to cut bait as soon as possible.

I am curious how you've navigated this.
 
Moonbeams said:
Have you noticed problems getting desirable employers to interview you and give you serious offers? I have noticed some employers getting hung up on leaving a prior job. They always want to know about the jump, and they don't seem satisfied with my truthful answer of being recruited with promises that were not fulfilled. From my standpoint, if I am recruited with specific promises that are not fulfilled, I will leave. However, prospective employers seem to view this negatively, as if I am supposed to tolerate an employer breaching my contract and creating a situation where I am unhappy for a certain period of time because I owe them something before it becomes OK for me to leave. Logically, it would make sense that as soon as you realize there is no long-term potential to cut bait as soon as possible.

I am curious how you've navigated this.
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I’ve had a few jobs over my career. I honestly believe people “get it” if you can explain your situation and willing to give them references, etc. I have colleagues in other specialties who moved around as well and agree life is to short to compromise.
 
Moonbeams said:
Have you noticed problems getting desirable employers to interview you and give you serious offers? I have noticed some employers getting hung up on leaving a prior job. They always want to know about the jump, and they don't seem satisfied with my truthful answer of being recruited with promises that were not fulfilled. From my standpoint, if I am recruited with specific promises that are not fulfilled, I will leave. However, prospective employers seem to view this negatively, as if I am supposed to tolerate an employer breaching my contract and creating a situation where I am unhappy for a certain period of time because I owe them something before it becomes OK for me to leave. Logically, it would make sense that as soon as you realize there is no long-term potential to cut bait as soon as possible.

I am curious how you've navigated this.
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You can DM me or call me. People tend to understand life happens
 
RealSimulD said:
If my parents were healthier, I’d try to live abroad.
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Where? I have seen nearly zero legit opportunities for rad onc abroad. I've looked into getting a license in a few western European countries before. The process is pretty onerous -- not impossible and would require a few years at least of brushing up on language skills and passing exams. Working in the US for higher pay then retiring early to spend time in Europe seems like a more realistic plan. I'm curious where a US-trained rad onc can go and practice outside of the US with minimal hurdles?
 
Moonbeams said:
Where? I have seen nearly zero legit opportunities for rad onc abroad. I've looked into getting a license in a few western European countries before. The process is pretty onerous -- not impossible and would require a few years at least of brushing up on language skills and passing exams. Working in the US for higher pay then retiring early to spend time in Europe seems like a more realistic plan. I'm curious where a US-trained rad onc can go and practice outside of the US with minimal hurdles?
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Supposedly NZ but ive never looked into it in detail. Germany is very tough and makes you take a full german language exam, takes years. Unsure about other european countries
 
Moonbeams said:
Where? I have seen nearly zero legit opportunities for rad onc abroad. I've looked into getting a license in a few western European countries before. The process is pretty onerous -- not impossible and would require a few years at least of brushing up on language skills and passing exams. Working in the US for higher pay then retiring early to spend time in Europe seems like a more realistic plan. I'm curious where a US-trained rad onc can go and practice outside of the US with minimal hurdles?
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The great Todd Scarborough nearly started in Oz. I interviewed for a position in Shanghai. Both jobs paid nearly same as US.
 
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thecarbonionangle said:
Supposedly NZ but ive never looked into it in detail. Germany is very tough and makes you take a full german language exam, takes years. Unsure about other european countries
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Germany is one of the specific countries I am aware of. You have to sit for an oral exam in German. There is a process to have them approve your medical school curriculum without the exam, but it involves a tedious review of every bit of coursework you did 10+ years ago. If one item is missing from the syllabus or was not in the correct spot, then it will be rejected, which of course it will because there is no way a German medical school and American medical school's curriculum will align exactly. So you have to sit for an oral exam testing medical school USMLE-level knowledge in German. Sounds fun. ABR's got nothing on the Germans... Paul Wallner could probably spend a few weeks in Berlin and learn a thing or two on how to better torture residents.
 
Moonbeams said:
Germany is one of the specific countries I am aware of. You have to sit for an oral exam in German. There is a process to have them approve your medical school curriculum without the exam, but it involves a tedious review of every bit of coursework you did 10+ years ago. If one item is missing from the syllabus or was not in the correct spot, then it will be rejected, which of course it will because there is no way a German medical school and American medical school's curriculum will align exactly. So you have to sit for an oral exam testing medical school USMLE-level knowledge in German. Sounds fun. ABR's got nothing on the Germans... Paul Wallner could probably spend a few weeks in Berlin and learn a thing or two on how to better torture residents.
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Americans are so soft.
 
Moonbeams said:
Germany is one of the specific countries I am aware of. You have to sit for an oral exam in German. There is a process to have them approve your medical school curriculum without the exam, but it involves a tedious review of every bit of coursework you did 10+ years ago. If one item is missing from the syllabus or was not in the correct spot, then it will be rejected, which of course it will because there is no way a German medical school and American medical school's curriculum will align exactly. So you have to sit for an oral exam testing medical school USMLE-level knowledge in German. Sounds fun. ABR's got nothing on the Germans... Paul Wallner could probably spend a few weeks in Berlin and learn a thing or two on how to better torture residents.
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Based on my friends who trained in Eastern Europe. Picture the old school attendings training residents…they absolutely hammer you. No stone is left unturned and there’s no credit for participation. Germans probably not much different.
 
There was a job on the Astro Career Center posted for New Zealand a couple of months ago. I believe US grads can practice in New Zealand without a huge amount of hassle. Pay will be less of course.
 
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jondunn said:
I know you seem miserable and misanthropic in every post
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gerry dee cbc GIF by Mr. D
 
Neuronix said:
Fixed that for you.
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I've seen "specialist" rad oncs switch to generalist jobs a few years out from training. Not the end of the world, probably harder the further out you get. It's the risk you take going into academics these days especially imo
 
medgator said:
I've seen "specialist" rad oncs switch to generalist jobs a few years out from training. Not the end of the world, probably harder the further out you get. It's the risk you take going into academics these days especially imo
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A lot of practices are biased against disease site specialized academics coming to join them unless they have a specific need for someone with expertise in that area. I mean if a place is more desperate they're usually more willing to take a risk, but you have to wonder why they're so desperate in this job market...
 
medgator said:
I've seen "specialist" rad oncs switch to generalist jobs a few years out from training. Not the end of the world, probably harder the further out you get. It's the risk you take going into academics these days especially imo
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I wonder if Jay Loeffler will be CNS only or generalist now that he's out in PP.
 
Neuronix said:
A lot of practices are biased against disease site specialized academics coming to join them unless they have a specific need for someone with expertise in that area. I mean if a place is more desperate they're usually more willing to take a risk, but you have to wonder why they're so desperate in this job market...
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Maybe some are. We were about to hire a prominent GI RadOnc. My friend left a community job, and they hired a site specific Academic doc that every single one of us has heard of. I think, again, if you have an open mind and are open to collaboration, seem like a good colleague/partner I don’t see it holding you back as much - but your lived experience is what it is and I am not saying it’s impossible. When we have to hire, I certainly wouldn’t say No to someone who was a site specialist for that reason alone.
 
RealSimulD said:
, I certainly wouldn’t say No to someone who was a site specialist for that reason alone.
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Not sure i would agree with that, esp someone who's only been treating one site for a decade+. The few I've talked to say they wouldn't feel comfortable being a generalist after years/decades of being site specific
 
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It seems to me, that compared to other medical specialties at least, there is at least some stigma moving around as a rad onc. Your expected to stay put and build relationships/the practice. Unfortunately, most of us don’t have any real ownership of that work. From a personal level it seems like just about everyone I know just kinda stays wherever they land after residency. I’m not saying there is anything wrong with finding the best situation for one’s self but there doesn’t seem to be a ton of that going on in rad onc. Even those who are not particularly happy in their practice seem to stay there year after year.
 
fiji128 said:
It seems to me, that compared to other medical specialties at least, there is at least some stigma moving around as a rad onc. Your expected to stay put and build relationships/the practice. Unfortunately, most of us don’t have any real ownership of that work. From a personal level it seems like just about everyone I know just kinda stays wherever they land after residency. I’m not saying there is anything wrong with finding the best situation for one’s self but there doesn’t seem to be a ton of that going on in rad onc. Even those who are not particularly happy in their practice seem to stay there year after year.
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Pulling a lateral has always been tough, more so in this market, esp if partnered in. You're essentially starting from the ground up again when you switch to a new PP
 
thecarbonionangle said:
Why exactly would a pp be interested in a washed up old proton guy? What is the grift here folks?
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He is basically a “billboard” . Probably a very good use of advertising dollars. If he brings in 20+ new pts a year because they can boast to all the referring docs, would be worth it.
 
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