Ranking the worst rad onc programs in the nation - for med students

[FrostyHammer]

This is a continuation of the other thread but different intent...I think med students reading SDN would benefit from having a list of the worst programs in the country. Many people have informally ranked the best ones, but if I were a med student over again, I'd want a list of the worst too, so as to make sure to avoid. So let's have everyone please rank the bottom 5-50 worst programs (the longer of a list, the better).

My list:
10. Miami
9. Kansas
8. Tennessee
7. West Virginia
6. Columbia
5. Allegany
4. LIJ
3. MUSC
2. NY Presbyterian
1. Baylor

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[Baws]

that's a fairly solid list tbh (as in those places are terrible lol)

 

[metview]

Here is my list. Would not attend any of these programs in this climate.

28. Stony brook
27. Uthsca
26. UCirvine
25.Loyola
24. Dartmouth
23. Upmc
22 Mayo Jax
21. SUNY downstate
20. SUNY upstate
19.TJU
18. ULouisville
17. UC Davis
16. Case Western
15. OU
14. Kentucky
13. Miami
12. Northwell LIJ
11. Texas a&m
10. UMississippi
9. Columbia
8. Alleghany
7. Kansas
6. UTennessee
5. Arkansas
4. MUSC
3. Baylor
2. WVU
1. NY Presby Methodist

 

[RickyScott]

How can Arkansas, Mississippi , Dartmouth,stony brook not appear. And Baylor Scott white/Texas am -so many contenders. Does eastern virginia also have a program?

 

[StIGMA]

This is almost identical to a list of programs I didn't apply to several years back... hard to argue with the order of the list without firsthand experience!

 

[medgator]

How can Arkansas, Mississippi , Dartmouth,stony brook not appear. And Baylor Scott white/Texas am -so many contenders. Does eastern virginia also have a program?

E va was shut down a decade ago iirc

 

[medgator]

Here is my list. Would not attend any of these programs in this climate.

26. Stony brook
25. Uthsca
24. UCirvine
23. Loyola
22. Dartmouth
21. Upmc
20. Mayo Jax
19. SUNY downstate
18. SUNY upstate
17. TJU
16. ULouisville
15. UC Davis
14. Case Western
13. OU
12. Kentucky
11. Miami
10. Northshore LIJ
9. Columbia
8. Alleghany
7. Kansas
6. UTennessee
5. Arkansas
4. MUSC
3. Baylor
2. WVU
1. NY Presby Methodist

Mississippi should be somewhere at #10-15.

Henry Ford used to get knocked back in the day too but i do know that Sam Ryu was a big name there

 

[drewdog1973]

 

[medgator]

View attachment 325852

Google search shows he's at stonybrook now. Don't hear much about Wayne states program either honestly

 

[metview]

Mississippi should be somewhere at #10-15.

Henry Ford used to get knocked back in the day too but i do know that Sam Ryu was a big name there

I didn't even know Mississippi and A&M were taking residents. They are both horrible places. Thanks for letting me know. I have edited the list!

 

[thecarbonionangle]

I didn't even know Mississippi and A&M were taking residents. They are both horrible places. Thanks for letting me know. I have edited the list!

They mostly focus on FMGs at mississippi and offer “fellowships” for them for cheap labour then they “may” let you in for four more years.

some of these places in this list love a good FMG “fellow”

 

[metview]

If half of those programs closed down, we'd be at a perfect spot. I'm surprised places like Mississippi and A&M need residents. We all know their attendings aren't doing research. Why do they need coverage? How lazy are these attendings? They can't even write a simple h&p that takes 10 mins to write?

 

[drewdog1973]

For people practicing at least ten years... what percentage of competency do you think comes from the individual vs the training program?

 

[RickyScott]

For people practicing at least ten years... what percentage of competency do you think comes from the individual vs the training program?

It is 90-99% individual.

 

[drewdog1973]

It is 90-99% individual.

I agree - 90-99%
Then why a **** list, if 90-99% is upon individual?

 

[RickyScott]

I agree - 90-99%
Then why a **** list, if 90-99% is upon individual?

It is circular reasoning. What kind of American md ,who has a lot of choices open to them, enter one of these programs in this job market.

 

[drewdog1973]

Also agree with that.

I think everyone should cut spots, indiscriminate to perceived “quality”.

This game of ranking the worst- they certainly aren’t going to cut spots or close down. Best possibility is having the larger players make moves. They also have resources to replace the residents with APPs, etc.

 

[RadOncDoc21]

Also agree with that.

I think everyone should cut spots, indiscriminate to perceived “quality”.

This game of ranking the worst- they certainly aren’t going to cut spots or close down. Best possibility is having the larger players make moves. They also have resources to replace the residents with APPs, etc.

Will never happen, doesn’t matter if quality of residents suck, less applicants, etc. The ones who have the power to make it happen just don’t care... period.

 

[thecarbonionangle]

Yea why improve anything if you can just teach yourself. Why even have any standards? That’s the “leadership” ASTRO neeeds. Deputy ASTRO president right here folks!

 

[medgator]

Also agree with that.

I think everyone should cut spots, indiscriminate to perceived “quality”.

This game of ranking the worst- they certainly aren’t going to cut spots or close down. Best possibility is having the larger players make moves. They also have resources to replace the residents with APPs, etc.

I think many would be fine with chronologically closing programs/erasing spots. I'd be fine with a thanos finger snap for any program created or expanded spots in 2010+

 

[medgator]

For people practicing at least ten years... what percentage of competency do you think comes from the individual vs the training program?

If the quality of individual in rad onc has been dropping (lower scores, increase FMGs/DOs/Carribean grads, all of which are felt to be markers of applicant quality), shouldn't that matter? Crappy applicant at crappy program likely makes a crappy rad onc? Maybe crappy applicant at good program might make up for it a bit?

 

[drewdog1973]

You can’t make chicken salad out of chicken ****

 

[drewdog1973]

Yea why improve anything if you can just teach yourself. Why even have any standards? That’s the “leadership” ASTRO neeeds. Deputy ASTRO president right here folks!

They’ve already tried to improve things.
Just cut spots already. Don’t think much about it. Not gonna save RO education. Better to save the specialty itself.

 

[RadOncDoc21]

Right stop the bleeding first.

 

[elementaryschooleconomics]

Right stop the bleeding first.

The "ABCs" of an emergency - airway, breathing, cut spots.

 

[RadOncDoc21]

The "ABCs" of an emergency - airway, breathing, cut spots.

Stop the airway then!

 

[scarbrtj]

For people practicing at least ten years... what percentage of competency do you think comes from the individual vs the training program?

Like Joni Mitchell, I have seen "Both Sides Now." I used to think it was >90% individual. Kind of like, you know, good Will Hunting. Or Einstein. He could have been at Texas A&M and still developed the photoelectric effect. But then there's the rest of us (Happy Fesitvus!). A bad program stunts you. It brainwashes you. It straitens your thinking without knowing it's straitened. One of the best things that can happen to you in training is to be exposed to REALLY worldly viewpoints and wide variations in pathologies... and variations in technologies. I was very lucky to have trained at a place that would never make one of these lists; but I have firsthand knowledge of a program or two on this list too.

 

[Ray D. Ayshun]

Given the state of things, I think the top 10 in this thread might see an increase in the number of applications they receive.

 

[elementaryschooleconomics]

Like Joni Mitchell, I have seen "Both Sides Now." I used to think it was >90% individual. Kind of like, you know, good Will Hunting. Or Einstein. He could have been at Texas A&M and still developed the photoelectric effect. But then there's the rest of us (Happy Fesitvus!). A bad program stunts you. It brainwashes you. It straitens your thinking without knowing it's straitened. One of the best things that can happen to you in training is to be exposed to REALLY worldly viewpoints and wide variations in pathologies... and variations in technologies. I was very lucky to have trained at a place that would never make one of these lists; but I have firsthand knowledge of a program or two on this list too.

This is what I think is important in the "big vs small program" argument.

My department drives me nuts. I feel like we're often left to our own devices to learn what we can - and I think a lot of programs are like that. I feel like very little effort is directed towards "intentional education".

However, my department is huge, and the attendings vastly outnumber the residents. The attendings who get residents have trained in three (or four) different decades. There is overlap in disease sites you see. At this point, nearing the end of residency, I have done things like lung SBRT under ~4 different people. While the general approach is the same, those attendings have different patterns of practice. Trying to adapt what I'm doing (workup, contouring, management, etc) to their expectations - and what I think we should be doing - is where most of my intangible learning comes from. I can memorize books with the best of them, and I think we all can, but this is one thing I can put my finger on as "beyond book learning". I agree with @scarbrtj - I can easily see how someone, if they're stuck in a certain singular practice pattern for all of residency, can develop blinders that are hard (impossible?) to shake.

I don't have any personal experience to add any programs to the lists above, other than to say - med students, it's probably best to avoid the "small" programs, and I would define small as not just having a few residents but also having few faculty. It's one thing if you've got 8 residents but rotate between 20 attendings, it's another if you've got 6 residents and 6 faculty.

 

[drewdog1973]

Re: Loyola

There is an axe. Someone wishes to grind it. So, here we are. You don’t have to any data or evidence to say anything and trash programs. Then, we wait until the Loyola PD comes on here to defend themselves. Then SDN trashes them. The circle of life, Mufasa would be proud!

 

[RickyScott]

Yea why improve anything if you can just teach yourself. Why even have any standards? That’s the “leadership” ASTRO neeeds. Deputy ASTRO president right here folks!

Re: Loyola

There is an axe. Someone wishes to grind it. So, here we are. You don’t have to any data or evidence to say anything and trash programs. Then, we wait until the Loyola PD comes on here to defend themselves. Then SDN trashes them. The circle of life, Mufasa would be proud!

I agree that Loyola should not make the list, but for the most part the list is quite solid.

 

[drewdog1973]

I agree that Loyola should not make the list, but for the most part the list is quite solid.

Based on what? “_____ is a no good, trash program, that is malignant, < insert hilarious quip > “

I too agree that many programs are poor - I’ve said it, too. But Davis? How would there be enough data points? Mayo Jax? How is it really worse than Galveston? It’s fine, carry on. I still enjoy it. San Antonio made the list. I’m sure dozens of our members both rotated and spent time as faculty there. What about Ohio State? Big center, but it’s never been discussed even.

popcorn eating emoji, please !

 

[medgator]

Based on what? “_____ is a no good, trash program, that is malignant, < insert hilarious quip > “

I too agree that many programs are poor - I’ve said it, too. But Davis? How would there be enough data points? Mayo Jax? How is it really worse than Galveston? It’s fine, carry on. I still enjoy it. San Antonio made the list. I’m sure dozens of our members both rotated and spent time as faculty there. What about Ohio State? Big center, but it’s never been discussed even.

popcorn eating emoji, please !

4 residents, 4 faculty at mayo jax when i applied, sitting in the shadow of UFs proton center where Gainesville's residents rotated.

Is Jax really that big enough to support two training programs? Could argue Scottsdale more deserving of having a program than the Jax satellite, but imo, no reason we shouldn't have controlled the primary tumor at rochester MN and never let the mets out to begin with

 

[RickyScott]

I think list needs to have asterisk next to some programs. Upmc, Jeff clearly not bottom tier program in terms of faculty, research but they may be malignant.
Bottom 10-15 should be tiny recent programs with near zero research/ and zero to offer- job prospects will be close to zero: West Virginia, Tennessee,Mississippi, Dartmouth, Arkansas, Scott and white, stony brook, Baylor- because it is apparently truly horrible.
Following that could be your Kansas, Irvine, Nebraska, indiana, Oklahoma,Columbia, LIJ etc and malignant midtiers like Jeff. Obviously some inherent error here- how can we truly know if Louisville is worse than Kentucky?

 

[elementaryschooleconomics]

Obviously some inherent error here- how can we truly know if Louisville is worse than Kentucky?

Right, and all it takes is one or two faculty changes (someone joining, someone leaving - especially a PD) and the entire culture of a place can flip on a dime.

 

[goodkerma]

The problem with this list is it really isn’t going to stop anyone from applying to radiation oncology and at the end of the day many ppl make decisions based on personal factors- apart from maybe a small percentage of hyper-focused career driven academic hopefuls. In regards to places with a county hospital being a bad place to train, I’d much rather work with someone who operated at a place where they were fundamental to patient care rather than a glorified medical student while PAs and NPs ran the show.

UoL, Jefferson and BCM have produced solid graduates. Hell the Baylor graduates historically have gotten some of the absolute best job placements in Texas.

 

[RadOncDoc21]

All I know is that my training was really crappy. I was able to teach myself rad onc and if I apply for jobs, my program will be stated as one of the best ever!

 

[RickyScott]

Worst : west viginia, Baylor, Arkansas, Tennessee, Dartmouth, stony brook, methodist, Mississippi

Pretty bad: LIJ, Kentucky,Louisville, Irvine, Davis Kansas, Oklahoma, Nebraska, indiana, San Antonio, Galveston, Columbia, Mayo Jax, SUNY anything, alleghany, musc,

Places that are mediocre, but you will still struggle to compete for a fellowship/actually are decent but malignant: upmc, tju, Miami,

no us md needs to touch anyof these programs. When decent job market, sure let geography dictate, but now many of few scarce jobs will be in large academic satellites.
Probably around 90 us mds will matriculate into radonc -and a very tenuous and odds still stacked against you -career: they can fill up top 25-30 programs: mdacc, mskc, Harvard, UPenn, wash u,Hopkins, Mayo, duke- malignant, Stanford- malignant, ucsf, Michigan, Florida, Chicago, Washington- malignant, Yale, Dallas, Wisconsin, Emory, Colorado, moffitt, Cleveland clinic
2nd tier-fox chase, North Carolina, Alabama, virginia, ucla, UCSD, Maryland- malignant, Jeff- malignant, upmc- apparently malignant, wake

edit- I am not implying that by going to a top tier program that you will land a job. You probably won’t.

 

[Ray D. Ayshun]

Lol. This has degenerated into the absurdity that is the interview spreadsheet. Lots of accusations based on very little. I basically have enough information to comment on a single program. Maybe 2 or 3 if you count home and away rotations. Otherwise, I wouldn't even venture a guess, particularly about what life is like on a day-to-day basis in the program.

 

[drewdog1973]

Lol. This has degenerated into the absurdity that is the interview spreadsheet. Lots of accusations based on very little. I basically have enough information to comment on a single program. Maybe 2 or 3 if you count home and away rotations. Otherwise, I wouldn't even venture a guess, particularly about what life is like on a day-to-day basis in the program.

Shh.. no one wants to hear that. They’d rather just talk smack on “trash no good programs” without consequence, hurting the residents currently training, many of whom matched 4-5 years ago and are cream of the crop and passionate about RO. Great work, mods! This thread will elevate us in the eyes of those trying to make things better!

 

[RickyScott]

Shh.. no one wants to hear that. They’d rather just talk smack on “trash no good programs” without consequence, hurting the residents currently training, many of whom matched 4-5 years ago and are cream of the crop and passionate about RO. Great work, mods! This thread will elevate us in the eyes of those trying to make things better!

I did not go to a very good program, because I cared about geography and job market was not an issue at the time. Few here are idiots and so beholden to program reps that they can’t recognize that an AOA type who matched at a place like Kansas 5 years ago is likely to be more capable than those who “snuck past security” and matched at top tier places this year.

 

[drewdog1973]

“Snuck past security” = one of the best lines I’ve seen recently. Perfectly described

 

[RickyScott]

“Snuck past security” = one of the best lines I’ve seen recently. Perfectly described

Over my career, I have certainly come across less
than competent docs who came from top tier places when standards and interest in the field was low. These were not guys “who tested well”, but lacked common sense. True *****s, but just took a pulse to get into the field.

 

[thecarbonionangle]

Some may not like “lists”. Even the best programs list generated plenty of controversies. This field has to reckon with fact that the standards for training programs is quite low and has been for some time. This has led to a large discrepancy of residency experiences even if everyone comes out “competent”.

people will always be butt hurt that their place, their friends place, the place they met someone who was “good” is up there. the argument is not that people come out of these places totally incompetent but that programs are being allowed to provide substandard and in some cases aweful residency experiences where you may as well just stayed home with perez and brady, nancy lee, and gunderson for four years and you would have learned more than from your so called “clinical program”.

in the curret environment it is truly important to not muddy the waters with suggestions that there is no such thing as a “bad program”. US MDs should avoid certain programs as the job market worsens.

 

[thecarbonionangle]

“Snuck past security” = one of the best lines I’ve seen recently. Perfectly described

As someone involved with reviewing applications, the ones sneaking by are coming through the vents and sinks. Just wait in 5 years where graduates will not be guaranteed to even be able to speak english. Think pathology. It is coming. It is here.

 

[temujim]

As someone involved with reviewing applications, the ones sneaking by are coming through the vents and sinks. Just wait in 5 years where graduates will not be guaranteed to even be able to speak english. Think pathology. It is coming. It is here.

Already here is right.

But look at the ACGME rad onc review committee. Many members have a vested interest in NOT changing anything. Only way to systemically change anything is to take over the committee, re-write the minimum requirements for programs such that requirements become difficult. Say a minimum of 8 residents per program with a minimum of 12 faculty at the main site (satellites don't count). Doing so would probably cut 2/3 of programs and 1/2 the spots.

 

[drewdog1973]

Fair points, but constant attacks based on personal vendettas don’t seem useful.

I don’t think many of us truly have that much experience to say that Arkansas, etc. are terrible (I don’t doubt they may be). I have met a few grads from places on this list and honestly very difficult to link competence with what residency they went to. I work with several from a “top” place and the consistent high rating of that place is baffling. Kaiser not on list. Is it because they hire their own and that means they have SoCal jobs so that makes it good? What about Minnesota? What’s good or bad about them versus Louisville or Mayo Jax?

 

[drewdog1973]

And re: bad experience but graduating competent? I’m okay with that. In fact, I’d rather that than the opposite. Ideally good experience and competent, but I’ll take competent.

CUT THE SPOTS! CUT THE SPOTS! The only good residency position is one that has been cut!

 

[drewdog1973]

Henry Ford? Wayne State? Rush? OHSU? Indiana?

 

[RickyScott]

And re: bad experience but graduating competent? I’m okay with that. In fact, I’d rather that than the opposite. Ideally good experience and competent, but I’ll take competent.

CUT THE SPOTS! CUT THE SPOTS! The only good residency position is one that has been cut!

Everybody graduating today should be competent, based on what it took to match! I would not have matched.