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It's time for my annual (kidding, I think I say this weekly) reminder that the ARRO graduating resident survey, which is held up as the best evidence that everything is fine in Radiation Oncology, is given to PGY5 residents in May/June, before they have graduated, before they have worked a single hour of whatever job they're planning on starting:

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As always: the data from the ARRO survey is the equivalent of asking a patient about radiation side effects a week before they start treatment.

(standard disclaimer: not knocking ARRO or anything like that, but this survey was not designed or deployed to be used the way it is used by SCAROP and friends)
 
Why has this not been changed to asking recently graduated residents about their job, say end of calendar year? And then follow up at 1 year post-graduation? Since surveys are very commonplace now it doesn't seem like that should be hard.

Surely somebody here has contacts at ARRO to make this happen or least investigate why?
 
I saw discussion of this on Twitter. They of course want to but logistically it’s a lot more challenging when it’s not done through the program. People’s emails change etc.

Hopefully in the future they try to do both. The response rates will always be highest now though. I think chelain on Twitter said she got to >90 percent when she was in charge
 
You would think if graduating residents cared about the future of our field (and their livelihood) - they could take the few minutes to go along with whatever changes happen. I would have. The data would be much more accurate and reflective of the real world.
 
jondunn said:
I saw discussion of this on Twitter. They of course want to but logistically it’s a lot more challenging when it’s not done through the program. People’s emails change etc.

Hopefully in the future they try to do both. The response rates will always be highest now though. I think chelain on Twitter said she got to >90 percent when she was in charge
Click to expand...
I bet the actual responses of non-responders would be skewing even though non-response rate is low.

The proportion of non-job/fellowship was significantly higher in 2021 vs 2020. ARRO did not mention this fact in its summaries.

EDIT: was a full public summary of results for 2021 ever released???
 
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metallica81788 said:
You would think if graduating residents cared about the future of our field (and their livelihood) - they could take the few minutes to go along with whatever changes happen. I would have. The data would be much more accurate and reflective of the real world.
Click to expand...

I’m sure I don’t have to tell you that busy people are busy people.

How many surveys do you fill out that you get? We are all human
 
jondunn said:
I’m sure I don’t have to tell you that busy people are busy people.

How many surveys do you fill out that you get? We are all human
Click to expand...

The Wallnerus has presented data on how most of us aren't that busy anymore, despite the outliers

I'm probably not going to fill out a survey on my Amazon order, but I'll do one if it even has potential to impact data for our field, compensation, job availability/quality, etc.
 
metallica81788 said:
The Wallnerus has presented data on how most of us aren't that busy anymore, despite the outliers

I'm probably not going to fill out a survey on my Amazon order, but I'll do one if it even has potential to impact data for our field, compensation, job availability/quality, etc.
Click to expand...
There’s doctor busy, and there’s rad onc busy

I suspect they’re different
 
Problem of diminished expectations. They are just so grateful they are not on the street. We all know that was a nagging fear in the back of their minds, keeping them up at night, etc and now they are relieved that they have “a” job- as the prior Astro president stresses.


“A poor man lived with his wife and six children in a very small one-room house. They were always getting in each other's way and there was so little space they could hardly breathe!
Finally the man could stand it no more. He talked to his wife and asked her what to do. "Go see the rabbi," she told him, and after arguing a while, he went.

The rabbi greeted him and said, "I see something is troubling you. Whatever it is, you can tell me."

And so the poor man told the rabbi how miserable things were at home with him, his wife, and the six children all eating and living and sleeping in one room. The poor man told the rabbi, "We're even starting to yell and fight with each other. Life couldn't be worse."

The rabbi thought very deeply about the poor man's problem. Then he said, "Do exactly as I tell you and things will get better. Do you promise?"

"I promise," the poor man said.

The rabbi then asked the poor man a strange question. "Do you own any animals?"

"Yes," he said. "I have one cow, one goat, and some chickens."

"Good," the rabbi said. "When you get home, take all the animals into your house to live with you."

The poor man was astonished to hear this advice from the rabbi, but he had promised to do exactly what the rabbi said. So he went home and took all the farm animals into the tiny one-room house.

The next day the poor man ran back to see the rabbi. "What have you done to me, Rabbi?" he cried. "It's awful. I did what you told me and the animals are all over the house! Rabbi, help me!"



The rabbi listened and said calmly, "Now go home and take the chickens back outside."

The poor man did as the rabbi said, but hurried back again the next day. "The chickens are gone, but Rabbi, the goat!" he moaned. "The goat is smashing up all the furniture and eating everything in sight!"
The good rabbi said, "Go home and remove the goat and may God bless you."

So the poor man went home and took the goat outside. But he ran back again to see the rabbi, crying and wailing. "What a nightmare you have brought to my house, Rabbi! With the cow it's like living in a stable! Can human beings live with an animal like this?"

The rabbi said sweetly, "My friend, you are right. May God bless you. Go home now and take the cow out of your house." And the poor man went quickly home and took the cow out of the house.

The next day he came running back to the rabbi again. "O Rabbi," he said with a big smile on his face, "we have such a good life now. The animals are all out of the house. The house is so quiet and we've got room to spare! What a joy!"
 
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RickyScott said:
Problem of diminished expectations. They are just so grateful they are not on the street. We all know that was a nagging fear in the back of their minds, keeping them up at night, etc and now they are relieved that they have “a” job- as the prior Astro president stresses.


“A poor man lived with his wife and six children in a very small one-room house. They were always getting in each other's way and there was so little space they could hardly breathe!
Finally the man could stand it no more. He talked to his wife and asked her what to do. "Go see the rabbi," she told him, and after arguing a while, he went.

The rabbi greeted him and said, "I see something is troubling you. Whatever it is, you can tell me."

And so the poor man told the rabbi how miserable things were at home with him, his wife, and the six children all eating and living and sleeping in one room. The poor man told the rabbi, "We're even starting to yell and fight with each other. Life couldn't be worse."

The rabbi thought very deeply about the poor man's problem. Then he said, "Do exactly as I tell you and things will get better. Do you promise?"

"I promise," the poor man said.

The rabbi then asked the poor man a strange question. "Do you own any animals?"

"Yes," he said. "I have one cow, one goat, and some chickens."

"Good," the rabbi said. "When you get home, take all the animals into your house to live with you."

The poor man was astonished to hear this advice from the rabbi, but he had promised to do exactly what the rabbi said. So he went home and took all the farm animals into the tiny one-room house.

The next day the poor man ran back to see the rabbi. "What have you done to me, Rabbi?" he cried. "It's awful. I did what you told me and the animals are all over the house! Rabbi, help me!"



The rabbi listened and said calmly, "Now go home and take the chickens back outside."

The poor man did as the rabbi said, but hurried back again the next day. "The chickens are gone, but Rabbi, the goat!" he moaned. "The goat is smashing up all the furniture and eating everything in sight!"
The good rabbi said, "Go home and remove the goat and may God bless you."

So the poor man went home and took the goat outside. But he ran back again to see the rabbi, crying and wailing. "What a nightmare you have brought to my house, Rabbi! With the cow it's like living in a stable! Can human beings live with an animal like this?"

The rabbi said sweetly, "My friend, you are right. May God bless you. Go home now and take the cow out of your house." And the poor man went quickly home and took the cow out of the house.

The next day he came running back to the rabbi again. "O Rabbi," he said with a big smile on his face, "we have such a good life now. The animals are all out of the house. The house is so quiet and we've got room to spare! What a joy!"
Click to expand...

The could be worse mentality is definitely pervasive in RO. Such sensibilities have done wonders for its health!
 
RickyScott said:
Problem of diminished expectations. They are just so grateful they are not on the street. We all know that was a nagging fear in the back of their minds, keeping them up at night, etc and now they are relieved that they have “a” job- as the prior Astro president stresses.


“A poor man lived with his wife and six children in a very small one-room house. They were always getting in each other's way and there was so little space they could hardly breathe!
Finally the man could stand it no more. He talked to his wife and asked her what to do. "Go see the rabbi," she told him, and after arguing a while, he went.

The rabbi greeted him and said, "I see something is troubling you. Whatever it is, you can tell me."

And so the poor man told the rabbi how miserable things were at home with him, his wife, and the six children all eating and living and sleeping in one room. The poor man told the rabbi, "We're even starting to yell and fight with each other. Life couldn't be worse."

The rabbi thought very deeply about the poor man's problem. Then he said, "Do exactly as I tell you and things will get better. Do you promise?"

"I promise," the poor man said.

The rabbi then asked the poor man a strange question. "Do you own any animals?"

"Yes," he said. "I have one cow, one goat, and some chickens."

"Good," the rabbi said. "When you get home, take all the animals into your house to live with you."

The poor man was astonished to hear this advice from the rabbi, but he had promised to do exactly what the rabbi said. So he went home and took all the farm animals into the tiny one-room house.

The next day the poor man ran back to see the rabbi. "What have you done to me, Rabbi?" he cried. "It's awful. I did what you told me and the animals are all over the house! Rabbi, help me!"



The rabbi listened and said calmly, "Now go home and take the chickens back outside."

The poor man did as the rabbi said, but hurried back again the next day. "The chickens are gone, but Rabbi, the goat!" he moaned. "The goat is smashing up all the furniture and eating everything in sight!"
The good rabbi said, "Go home and remove the goat and may God bless you."

So the poor man went home and took the goat outside. But he ran back again to see the rabbi, crying and wailing. "What a nightmare you have brought to my house, Rabbi! With the cow it's like living in a stable! Can human beings live with an animal like this?"

The rabbi said sweetly, "My friend, you are right. May God bless you. Go home now and take the cow out of your house." And the poor man went quickly home and took the cow out of the house.

The next day he came running back to the rabbi again. "O Rabbi," he said with a big smile on his face, "we have such a good life now. The animals are all out of the house. The house is so quiet and we've got room to spare! What a joy!"
Click to expand...
Rad onc job search joke (norm macdonald on conan, which is on youtube)

“A moth goes into a podiatrist’s office, and the podiatrist’s office says, “What seems to be the problem, moth?”

The moth says “What’s the problem? Where do I begin, man? I go to work for Gregory Illinivich, and all day long I work. Honestly doc, I don’t even know what I’m doing anymore. I don’t even know if Gregory Illinivich knows. He only knows that he has power over me, and that seems to bring him happiness. But I don’t know, I wake up in a malaise, and I walk here and there… at night I…I sometimes wake up and I turn to some old lady in my bed that’s on my arm. A lady that I once loved, doc. I don’t know where to turn to. My youngest, Alexendria, she fell in the…in the cold of last year. The cold took her down, as it did many of us. And my other boy, and this is the hardest pill to swallow, doc. My other boy, Gregarro Ivinalititavitch… I no longer love him. As much as it pains me to say, when I look in his eyes, all I see is the same cowardice that I… that I catch when I take a glimpse of my own face in the mirror. If only I wasn’t such a coward, then perhaps…perhaps I could bring myself to reach over to that cocked and loaded gun that lays on the bedside behind me and end this hellish facade once and for all…Doc, sometimes I feel like a spider, even though I’m a moth, just barely hanging on to my web with an everlasting fire underneath me. I’m not feeling good."

And so the doctor says, “Moth, man, you’re troubled. But you should be seeing a psychiatrist. Why on earth did you come here?”

And the moth says, “‘Cause the light was on.”
 
medgator said:
Click to expand...

I know a PP attending in Florida let go from her job about a year ago. She hasn't found work since.

An academic attending at MUSC lost his job under weird circumstances (no scandal AFAIK) a few years back and no one has heard from him since and guarantee you that kid wants to work.

Did Eichler get a job super quick? Did Heron wander in the wilderness?

A lot of people almost die, but only a vanishing minority appear on the TV show "The Day I Almost Died" and openly advertise it.
 
TheWallnerus said:
I know a PP attending in Florida let go from her job about a year ago. She hasn't found work since.

An academic attending at MUSC lost his job under weird circumstances (no scandal AFAIK) a few years back and no one has heard from him since and guarantee you that kid wants to work.

Did Eichler get a job super quick? Did Heron wander in the wilderness?

A lot of people almost die, but only a vanishing minority appear on the TV show "The Day I Almost Died" and openly advertise it.
Click to expand...

I know of a female radonc who graduated 8 years ago. Husband is a specialist MD. She never found work as a radonc and will never work in medicine.

I also know of a radonc who used to be local until he was let go by his group. Was unable to find work locally or even in-state, so is now working across the country while his family is here. They got tired of being relocated. So it goes.

If KO doesn't know of any anecdotes about problems finding work in the field, that says far, far more about him than it does about radonc.
 
metallica81788 said:
Why has this not been changed to asking recently graduated residents about their job, say end of calendar year? And then follow up at 1 year post-graduation? Since surveys are very commonplace now it doesn't seem like that should be hard.

Surely somebody here has contacts at ARRO to make this happen or least investigate why?
Click to expand...
any person on this forum could do this study, why hasnt anyone here done it?
 
radiation said:
any person on this forum could do this study, why hasnt anyone here done it?
Click to expand...

Because I am not an academic radonc. I am not in charge of residency programs and have no ability to increase or decrease the resident complement. Producing research about the field is not my job.

As I told someone today who wanted me to prepare an hour-long presentation for a bunch of occupational therapists about head and neck radiation, "I do not have the bandwidth to do unreimbursed work."
 
OTN said:
Because I am not an academic radonc. I am not in charge of residency programs and have no ability to increase or decrease the resident complement. Producing research about the field is not my job.

As I told someone today who wanted me to prepare an hour-long presentation for a bunch of occupational therapists about head and neck radiation, "I do not have the bandwidth to do unreimbursed work."
Click to expand...
Finally, a rad onc with some balls!
 
OTN said:
Because I am not an academic radonc. I am not in charge of residency programs and have no ability to increase or decrease the resident complement. Producing research about the field is not my job.

As I told someone today who wanted me to prepare an hour-long presentation for a bunch of occupational therapists about head and neck radiation, "I do not have the bandwidth to do unreimbursed work."
Click to expand...

I’ll have to start dropping that line.
 
OTN said:
Because I am not an academic radonc. I am not in charge of residency programs and have no ability to increase or decrease the resident complement. Producing research about the field is not my job.

As I told someone today who wanted me to prepare an hour-long presentation for a bunch of occupational therapists about head and neck radiation, "I do not have the bandwidth to do unreimbursed work."
Click to expand...
lol my response to attendings who try to get me to finish research projects as a PGY-5.
 
OTN said:
Because I am not an academic radonc. I am not in charge of residency programs and have no ability to increase or decrease the resident complement. Producing research about the field is not my job.

As I told someone today who wanted me to prepare an hour-long presentation for a bunch of occupational therapists about head and neck radiation, "I do not have the bandwidth to do unreimbursed work."
Click to expand...
Expecting academic rad onc to do work that is likely going to make academic rad onc look bad is not going to be an effective strategy. Look how much we scrutinize the data that ARRO produces right now - if they did the survey for 1st attendings and it showed a favorable job market would you believe it?

There have been countless posts about the Sinclair Upton quote. “It is difficult to get a man to understand something, when his salary depends on his not understanding it.” Why are we expecting academics to have some epiphany that is not likely going to help them?

What really needs to be done is a non-academic, non-ASTRO workforce survey that is grassroots and unbiased. We all know how the workforce is affecting the whole field - we all have enough skin in this such that non-academics should be interested obtaining this data. Getting a true lay of the lay in terms of salaries, job satisfaction etc is more than just academic work - it is due diligence
 
radiation said:
Expecting academic rad onc to do work that is likely going to make academic rad onc look bad is not going to be an effective strategy. Look how much we scrutinize the data that ARRO produces right now - if they did the survey for 1st attendings and it showed a favorable job market would you believe it?

There have been countless posts about the Sinclair Upton quote. “It is difficult to get a man to understand something, when his salary depends on his not understanding it.” Why are we expecting academics to have some epiphany that is not likely going to help them?

What really needs to be done is a non-academic, non-ASTRO workforce survey that is grassroots and unbiased. We all know how the workforce is affecting the whole field - we all have enough skin in this such that non-academics should be interested obtaining this data. Getting a true lay of the lay in terms of salaries, job satisfaction etc is more than just academic work - it is due diligence
Click to expand...
Do you think that's going to change the outcome of what these people end up doing after the data were to come out? Doubtful.

Many of them are still in denial of any problems to begin with (problems they themselves created) and have instead focused on med student outreach, DEI initiatives etc, Anything to avoid facing reality and cutting spots

 
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medgator said:
Do you think that's going to change the outcome of what these people end up doing after the data were to come out? Doubtful.

Many of them are still in denial of any problems to begin with (problems they themselves created) and have instead focused on med student outreach, DEI initiatives etc, Anything to avoid facing reality and cutting spots

Click to expand...

are you saying we shouldnt try to collect the data because of how it might be used?
 
radiation said:
are you saying we shouldnt try to collect the data because of how it might be used?
Click to expand...
No I think it's great, i just think you may be misguided by its potential effects once it is collected:

Expecting academic rad onc to do work that is likely going to make academic rad onc look bad is not going to be an effective strategy.
Click to expand...
And you would be correct but it will hopefully add more credence to why med students may want to think twice before selecting RO as a specialty in the near future.

I'm guessing it will be perfectly suited to be done by an organization like ACRO. Even KO came to that conclusion

 
Dont forget to fill out your ASTRO member survey. There were some very good questions in it about job market, future of field concerns. I marked these as my top priority. Please fill out and make your voices heard folks!
 
jondunn said:
Click to expand...


Is it uncommon for radoncs to follow their patients after treatment? I follow everyone. A lot. Part of the job. As a result, I really don't think it should be surprising that patients have worsened bowel function after CRT for anal cancer, or that it impacts sexual function. These are toxicities that we should be helping to manage in both the short- and long-term.

While I am very glad Dr. Emma Holliday is doing this research, from that standpoint, we should be well past the "these are the toxicities patients are reporting in the long-term" phase of things and deep into "here are the interventions we've tested to help these toxicities, and here's what works."

We talk about wanting to be "clinical oncologists" and to be respected for our clinical acumen, but if we're not following our patients long-term it's going to be hard for us to achieve that goal.
 
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