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

[radonc17]

So it goes without saying that many people complete a difficult residency convincing themself that working one's a** off is the ONLY way to be well-trained...

However, I also think there is some utility for a resident to FEEL LIKE everything is your responsibility (even if it isn't). You can either learn how to overcome feeling overwhelmed as a resident (when the stakes are low and you have a safety net beneath you), or as an attending.


I don't think it is wrong to demand a lot of a resident (even a junior one) so long as you give a lot in return in terms of teaching, going over contours, and spending time at the end of a long clinic day to let them practice looking at ports.

I agree with the spirit of what you’re saying, but practically this rarely happens

At the end of a long clinic day (let’s say 5-6 pm?), attending needs to go home to their family/life

They aren’t staying behind at that time to review contours with you

Instead what happens is one goes home as a young resident feeling exhausted, defeated, overwhelmed

Yet they still have to prep for next day while also learning the basics of radonc

Alternatively, you learn during your attendings academic day, which is becoming increasingly rare...

To me it’s not about avoiding work, but rather recognizing the deficiencies in training education and finding ways to fix it

A gradual build up seems like a good solution IMO

---

Members don't see this ad.

 

[thecarbonionangle]

I agree with the spirit of what you’re saying, but practically this rarely happens

At the end of a long clinic day (let’s say 5-6 pm?), attending needs to go home to their family/life

They aren’t staying behind at that time to review contours with you

Instead what happens is one goes home as a young resident feeling exhausted, defeated, overwhelmed

Yet they still have to prep for next day while also learning the basics of radonc

Alternatively, you learn during your attendings academic day, which is becoming increasingly rare...

To me it’s not about avoiding work, but rather recognizing the deficiencies in training education and finding ways to fix it

A gradual build up seems like a good solution IMO

Nailed it. This is what happens in many places. You see all patients and all inpatients and all follow ups and all consults and attending says thanks for your help at the end of day, if they even say that, and they go home at 6ish and now you have to contour, prep for an equally busy day the following day and teach yourself a field that people around you are getting paid to teach you yet it seems all you do is write notes and do menial tasks. You’re lucky if maybe some learning pixy dust is shaken off. Over time this is demoralizing and a terrible feeling. This is common in a “very clinical program”

 

[dieABRdie]

They aren’t staying behind at that time to review contours with you

If they are a certain attending moderator on this board..... they are staying behind at that time and doing the contours FOR you

 

[fiji128]

Nailed it. This is what happens in many places. You see all patients and all inpatients and all follow ups and all consults and attending says thanks for your help at the end of day, if they even say that, and they go home at 6ish and now you have to contour, prep for an equally busy day the following day and teach yourself a field that people around you are getting paid to teach you yet it seems all you do is write notes and do menial tasks. You’re lucky if maybe some learning pixy dust is shaken off. Over time this is demoralizing and a terrible feeling. This is common in a “very clinical program”

How this actually played out where I was, was that the senior residents would be the ones who actually taught the junior residents. It was very rare for the attendings to spend anytime teaching contouring and the nuts and bolts of their disease sites. I was at a place where residents were to always do all normal OAR contours except for lungs and bones because it was good “practice” to give some idea. Places was busy as residents could expect to log 1,000+ cases in residency. Program was kinda on the acgme’s radar for a bit for the poor educational quality but nothing ever really happened. It is almost always listed on these list of places to avoid.

 

[elementaryschooleconomics]

yet it seems all you do is write notes and do menial tasks.

I would like to consider myself highly skilled at working through the MRI safety questionnaire with a patient at 6:45AM before brachy THANK YOU VERY MUCH

 

[radonc17]

If they are a certain attending moderator on this board..... they are staying behind at that time and doing the contours for you

Ha I don’t view attendings ever doing contours as “for me”

I mean they only make 5x more than I do 😉

 

[Neuronix]

If they are a certain attending moderator on this board..... they are staying behind at that time and doing the contours for you

and I thought I was sitting here stewing all alone

I had a resident with me for 3 months this past year. I do have one right now and he saw 8 of the 17 patients I saw today (plus simulations and machine coverage for new starts and SBRTs).

Anyway, just an evil, lazy academic attending posting here. Don't mind me--go back to your usual bashing.

 

[radonc17]

and I thought I was sitting here stewing all alone

I had a resident with me for 3 months this past year. I do have one right now and he saw 8 of the 17 patients I saw today (plus simulations and machine coverage for new starts and SBRTs).

Anyway, just an evil, lazy academic attending posting here. Don't mind me--go back to your usual bashing.

@Neuronix - you are one of the good ones!

On behalf of your resident, thank you for what you do!

 

[Neuronix]

@Neuronix - you are one of the good ones!

On behalf of your resident, thank you for what you do!

I dunno. I have my share of haters.

 

[elementaryschooleconomics]

I dunno. I have my share of haters.

Only when the topic of MGMA salary comes up...

 

[Neuronix]

Only when the topic of MGMA salary comes up...

No, that's me hating out of jealousy that someone actually makes MGMA median

25th percentile AAMC assistant professor 4 lyfe.

 

[gmsquid]

and I thought I was sitting here stewing all alone

I had a resident with me for 3 months this past year. I do have one right now and he saw 8 of the 17 patients I saw today (plus simulations and machine coverage for new starts and SBRTs).

Anyway, just an evil, lazy academic attending posting here. Don't mind me--go back to your usual bashing.

I too could agree with this, except I have a resident 6-9 months of the year.

 

[Lamount]

I agree with the spirit of what you’re saying, but practically this rarely happens

At the end of a long clinic day (let’s say 5-6 pm?), attending needs to go home to their family/life

They aren’t staying behind at that time to review contours with you

Instead what happens is one goes home as a young resident feeling exhausted, defeated, overwhelmed

Yet they still have to prep for next day while also learning the basics of radonc

Alternatively, you learn during your attendings academic day, which is becoming increasingly rare...

To me it’s not about avoiding work, but rather recognizing the deficiencies in training education and finding ways to fix it

A gradual build up seems like a good solution IMO

I wasn’t speaking in hypotheticals. This is what I try to do with my residents.

Few of us have any concept of what training is like for others. I was fortunate to have some good attendings... and I try to pay it forward.

 

[gmsquid]

I also think there’s a balance and residents should work hard and beyond clinic hours. I don’t think residency is a 9-5 job. Residents should spend time outside work reading and studying and finishing notes and contouring. As an attending I’m routinely at work beyond those hours. I come early and stay late to contour and finish notes because I spend time teaching and doing other academic commitments throughout the day. It’s a time sacrifice on my part to teach and give talks to residents just like it is to do other stuff like write grants and papers. Doing academics well is more hours than a 9-5. And frequently for far less pay than pp. So as much as I get the bashing of academia for over expansion of residency slots and support the cause, it’s not fair to not recognize the sacrifice in time and money it takes to do good work in academics (teaching, research, service, etc.)

 

[drewdog1973]

I also think there’s a balance and residents should work hard and beyond clinic hours. I don’t think residency is a 9-5 job. Residents should spend time outside work reading and studying and finishing notes and contouring. As an attending I’m routinely at work beyond those hours. I come early and stay late to contour and finish notes because I spend time teaching and doing other academic commitments throughout the day. It’s a time sacrifice on my part to teach and give talks to residents just like it is to do other stuff like write grants and papers. Doing academics well is more hours than a 9-5. And frequently for far less pay than pp. So as much as I get the bashing of academia for over expansion of residency slots and support the cause, it’s not fair to not recognize the sacrifice in time and money it takes to do good work in academics (teaching, research, service, etc.)

Hopefully, most of us have had an attending (or many attendings) like that. Unfortunately, in RadOnc, it is the exception rather than the rule. It’s very hard to find great teachers. They tend to congregate at certain centers and the mid range / lower tier programs have very few excellent attendings. Not that the high rank place have all great teachers - it’s just more likely to find them there.

Also ...

CUT THE SPOTS! CUT THE SPOTS! Get out the machete and just randomly start cutting spots. It can be like the reverse of the NBA lottery. Larger programs have more balls to be drawn from, and just let ‘er rip!

 

[The Angle Lock]

WashU and UCLA have both had MRI linac fellows to my knowledge, wouldn't be surprised if there are more lurking out there.

UCLA's fellowship was not what you think it is. There was one fellow, two years ago, who was a radonc attending at Institut Paoli Calmettes (IPC) in Marseilles that wanted a year in the US to learn about adaptive RT and get involved in nitty-gritty details of planning. She brought her own funding from her home institution with a match from ViewRay. There has since been no further fellow.

 

[RadOncDoc21]

UCLA's fellowship was not what you think it is. There was one fellow, two years ago, who was a radonc attending at Institut Paoli Calmettes (IPC) in Marseilles that wanted a year in the US to learn about adaptive RT and get involved in nitty-gritty details of planning. She brought her own funding from her home institution with a match from ViewRay. There has since been no further fellow.

Still it seems kinda suspect to create a “fellowship” position...no?

 

[RadOncDoc21]

I wasn’t speaking in hypotheticals. This is what I try to do with my residents.

Few of us have any concept of what training is like for others. I was fortunate to have some good attendings... and I try to pay it forward.

I get it there are “good people on both sides” and you and a few others on here sound like rare bird attendings and I’m sure your residents love you, but I really need for someone who has a voice (maybe you Dr. All Star academic attending) to start trying to turn this ship around.

Are you an advocate for decreasing the amount of residency positions?

“With great power, comes great responsibility.”
-Uncle B

 

[Lamount]

That sucks. I know there a different styles but I think there is one superior way to teach contouring (which is my style that I learned as a resident): have the resident contour the case. Then, I turn their contours off, do my own, and we compare them together and discuss the differences. Makes it much easier to distinguish style vs key aspects. I also have them write a planning note (with me right when we finish reviewing the contours) with specific dose objectives. It helps dosimetry but also repetition is the best way to learn these things. Takes time, but that’s the point of working at an academic center.

This is exactly what I do as well. I think it takes less time for me because I am a little finicky and it would take longer to edit than to just do it from scratch... and very few of my cases are actually bread-and-butter so our differences can be substantial. I will do this with things like the brachial plexus as well.

 

[metallica81788]

I wish there would have been a single attending like some of you at my program. Just one.

 

[kluckylouie]

Why is Columbia's program so bad?

 

[The Angle Lock]

Still it seems kinda suspect to create a “fellowship” position...no?

No. A foreign attending wanted to spend a year in the US and learn about planning with the ViewRay. The position was created for this person as they needed to be employed in some capacity for a variety of reasons including HR. There was no open position and there has not been one since.

 

[Irradi8or]

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. Northshore 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

Reasonable list. Sorry if missed it, but would add the U of AZ program to this list given its decline over last several years

 

[StIGMA]

Why is Columbia's program so bad?

It's just a small program. Residents are treated well overall. It's not malignant or scutty. Wouldn't call it a bad program, but there are bigger/more dynamic programs within NYC and elsewhere. Research opportunities at Columbia (at the university level) are great if you are into that. It definitely does not need to expand. They've had as many/more residents than full clinical faculty until recently. Biggest radonc/radbio name I can think of there was Eric Hall until he aged out

 

[medgator]

It's just a small program. Residents are treated well overall. It's not malignant or scutty. Wouldn't call it a bad program, but there are bigger/more dynamic programs within NYC and elsewhere. Research opportunities at Columbia (at the university level) are great if you are into that. It definitely does not need to expand. They've had as many/more residents than full clinical faculty until recently. Biggest radonc/radbio name I can think of there was Eric Hall until he aged out

Any program willing to offer an inpatient palliative radiation "fellowship" deserves heaps of shaming

 

[drewdog1973]

Any program willing to offer an inpatient palliative radiation "fellowship" deserves heaps of shaming

What can possibly be learned from this fellowship??

 

[medgator]

What can possibly be learned from this fellowship??

30/5 vs 30/10 vs 8/1 vs hospice. Shouldn't take a year though

 

[StIGMA]

Any program willing to offer an inpatient palliative radiation "fellowship" deserves heaps of shaming

I agree fully! Let's hire a fellow to... handle our simple stuff and also teach our residents so we don't need to work with them as much! Great idea!

 

[RickyScott]

The thing about the cornell situation is that there are many hellpits just like that getting full accreditation year after year, so the system is broken. The burning giant pile of manure that is these places, will never be put out unless the acgme begins closing down many programs. This takes leadership. I know one of former residents may have had the option to end up at msk, not sure if thats what they chose. Most of the cpmc residents ended up at stanford i think so things always end up working out.

Frothing at mouth formenti should never be allowed near a radiation program again and Cornell should never be allowed to reopen. Other NYP programs should be shut down and a better future and education guaranteed for residents. Let cornell go into the history books a a shut down place like Univ of NM, east carolina, george washington, howard, etc.

Hi

It's just a small program. Residents are treated well overall. It's not malignant or scutty. Wouldn't call it a bad program, but there are bigger/more dynamic programs within NYC and elsewhere. Research opportunities at Columbia (at the university level) are great if you are into that. It definitely does not need to expand. They've had as many/more residents than full clinical faculty until recently. Biggest radonc/radbio name I can think of there was Eric Hall until he aged out

When I interviewed there many years ago, they had around 30-40 pts on beam and a chairman who looked like captain kangaroo.

 

[RadOncDoc21]

Haha, you guys bringing back my good ol rad onc palliative care fellowship!!

 

[drewdog1973]

Hi

When I interviewed there many years ago, they had around 30-40 pts on beam and a chairman who looked like captain kangaroo.

Dr. LK may enjoy failing people for no reason, but she does not look like a kangaroo!

 

[Ray D. Ayshun]

30/5 vs 30/10 vs 8/1 vs hospice. Shouldn't take a year though

30/10, then to hospice, no? Vs hospice? Its neoadjuvant rt

 

[ramsesthenice]

What can possibly be learned from this fellowship??

How quickly your debt increases with compound interest.

 

[GI_RadOnc]

How quickly your debt increases with compound interest.

There will always be a few fellowships; and they (should be) for someone to add something to your resume so that you can get the job that you want, when you want. We don't have fellowships; but people who have asked us for one often had personal situations where they needed a certain job, in a certain location, for a short time. They fill tumor databases, write papers, write grants, get visas, start a family... for VERY SELECTED FOLKS in this position, they are not abusive.

Agree with all other posters that this should be the minority of jobs... but I don't see the point in shaming institutions that have them.

 

[ramsesthenice]

but people who have asked us for one often had personal situations where they needed a certain job, in a certain location, for a short time. They fill tumor databases, write papers, write grants, get visas, start a family... for VERY SELECTED FOLKS in this position, they are not abusive

I agree that they should be available as on demand offering. I think the concept of a program trying to fill an advertised fellowship is a different animal.

 

[thecarbonionangle]

I just looked at the so called “google doc” after a long hiatus checking up on some hell pit places. One of them (on my list) boasts a 70 percent first pass board rate in a so called “desirable” area. There are some additional in my list with multiple failures over the years. Pay attention folks. The truth is out there if you seek it. Match day 2021 approaches.

 

[thecarbonionangle]

The rank lists are due soon. Beware, folks. Refer to post #97 on this thread.

don’t say you were not warned.

 

[evilbooyaa]

The rank lists are due soon. Beware, folks. Refer to post #97 on this thread.

don’t say you were not warned.

Would remove Iowa from your list unless there was some malignancy pattern there.

Not sure what issue with USC is either besides having to deal with county hospital as part of the residency.

 

[thecarbonionangle]

Would remove Iowa from your list unless there was some malignancy pattern there.

Not sure what issue with USC is either besides having to deal with county hospital as part of the residency.

Iowa has had multiple board failures. I think it’s sticking around in hellpit list.

USC is scut central county hospital. Not an ideal environment. Also boasts a 70 pct board pass rate.

CHOOSE WISELY, folks!

 

[radonc17]

Would remove Iowa from your list unless there was some malignancy pattern there.

Not sure what issue with USC is either besides having to deal with county hospital as part of the residency.

I don’t know much about Iowa training etc,
but I believe there is a mandatory basic science research component

I’m not a basic science person at all, so just throwing it out there as something to consider

 

[ramsesthenice]

I don’t know much about Iowa training etc,
but I believe there is a mandatory basic science research component

I’m not a basic science person at all, so just throwing it out there as something to consider

Nope. They are in our region and I am pretty familiar with the program. They have to take some classes with the rad bio students but there is not research requirement. Its a pretty solid mid tier program. Not sure why there would be issues with boards there.

 

[RickyScott]

I don’t know much about Iowa training etc,
but I believe there is a mandatory basic science research component

I’m not a basic science person at all, so just throwing it out there as something to consider

Why would anyone mandate basic science training? Not sure Iowa deserves to be named as bottom tier, but certainly grads will struggle. Buffalo and Rochester are in similar boat. No reason for US MD to attend any of these.

 

[thecarbonionangle]

Why would anyone mandate basic science training? Not sure Iowa deserves to be named as bottom tier, but certainly grads will struggle. Buffalo and Rochester are in similar boat. No reason for US MD to attend any of these.

Buffalo I have always heard its decent solid place. It is just located in an absolute tundra. Rochester is same. They were not included because I don’t know bad things about it, but certainly feel free to share if you know more. The hellpit list has been out for a while for comment, so it is interesting to me Iowa is seen as controversial.

 

[RickyScott]

Buffalo I have always heard its decent solid place. It is just located in an absolute tundra. Rochester is same. They were not included because I don’t know bad things about it, but certainly feel free to share if you know more. The hellpit list has been out for a while for comment, so it is interesting to me Iowa is seen as controversial.

they are not bottom dwellers, nor do I have knowledge of anything negative going on. Training is fine, but that will not be enough.

 

[medgator]

Buffalo I have always heard its decent solid place. It is just located in an absolute tundra. Rochester is same. They were not included because I don’t know bad things about it, but certainly feel free to share if you know more. The hellpit list has been out for a while for comment, so it is interesting to me Iowa is seen as controversial.

The upstate programs are decent... Just crap location and completely unnecessary in the modern era of residency slot oversupply

 

[ramsesthenice]

Why would anyone mandate basic science training? Not sure Iowa deserves to be named as bottom tier, but certainly grads will struggle. Buffalo and Rochester are in similar boat. No reason for US MD to attend any of these.

My wife is from up there and I interviewed at both places for faculty positions. I thought they seemed pretty solid. I didn’t see any obvious red flags. Like Iowa their biggest issue seems to be location.

 

[evilbooyaa]

I don’t know much about Iowa training etc,
but I believe there is a mandatory basic science research component

I’m not a basic science person at all, so just throwing it out there as something to consider

I don't think that's true.

When I interviewed there years ago for residency, they did seem enamored with my basic science research and seemed let down when I said I never wanted to do it again. I'm sure that affected rank lists on both sides (know it did on mine)

It may seem 'mandatory' as they seem to select for basic science folks, I suppose.

Why would anyone mandate basic science training? Not sure Iowa deserves to be named as bottom tier, but certainly grads will struggle. Buffalo and Rochester are in similar boat. No reason for US MD to attend any of these.

Only issue with Buffalo and Rochester is location and cold. Both are nice mid-tier programs in small cities if you can get over the cold aspect. People do it for Ann Arbor, Mayo Clinic, and U of Wisconsin

 

[ramsesthenice]

The hellpit list has been out for a while for comment, so it is interesting to me Iowa is seen as controversial.

These lists will always have some controversy. Everyone has their own sources and opinions. There was a lot commonality between the lists. Pretty sure prospective folks should know the repeat offenders are without a doubt the worst of the worst. No need to not pick each and every choice.

When I said Iowa was solid I meant their faculty/resident ration is > 1, they have good patient volumes, a busy HDR program, MR linac, GK, etc. and residents can and have done Holman if they want. Cant say the same for all Midwest programs.

 

[Lebron's hairline]

What's the reputation surrounding UCSD's program?

 

[thecarbonionangle]

What's the reputation surrounding UCSD's program?

Newish program but great place. Back in the day, good luck matching there, now who knows with warm body match coming up.