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

[radonc17]

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.



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

That was what I had heard, but sounds like it’s not required.

my apologies in that case.

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[ramsesthenice]

What's the reputation surrounding UCSD's program?

They are a relatively new program but recruited some pretty good faculty and their grads seem to have been doing pretty well getting good jobs. I am not aware of any issues.

 

[RickyScott]

They are a relatively new program but recruited some pretty good faculty and their grads seem to have been doing pretty well getting good jobs. I am not aware of any issues.

but good luck finding a socal job afterward.

 

[fiji128]

University of California San Diego started taking residents in 2010/11. It has always been considered a very strong program from the get go.

 

[thecarbonionangle]

University of California San Diego started taking residents in 2010/11. It has always been considered a very strong program from the get go.

Same with UTSW

 

[Lamount]

What's the reputation surrounding UCSD's program?

I've heard nothing but good things

 

[medgator]

I've heard nothing but good things

Aren't they known for some good brachy attendings? At least they used to be...

 

[radonc17]

What's the reputation surrounding UCSD's program?

reputation level of “wish I had gotten an interview invite” ha

 

[Doctorer]

This is kind of the issue. UCSD is a program that started in 2010/2011. Is it a good program? I don't know, maybe? I'm sure it's "fine," but if we're honest, we didn't need another program in Southern California that catered to Med Students Who Like The Beach, Craft Beer, and Good Cocktails.

 

[elementaryschooleconomics]

This is kind of the issue. UCSD is a program that started in 2010/2011. Is it a good program? I don't know, maybe? I'm sure it's "fine," but if we're honest, we didn't need another program in Southern California that catered to Med Students Who Like The Beach, Craft Beer, and Good Cocktails.

They also like hiking!

 

[fiji128]

Aren't they known for some good brachy attendings? At least they used to be...

Arno Mundt and Catheryn Yashar are there.

 

[fiji128]

This is kind of the issue. UCSD is a program that started in 2010/2011. Is it a good program? I don't know, maybe? I'm sure it's "fine," but if we're honest, we didn't need another program in Southern California that catered to Med Students Who Like The Beach, Craft Beer, and Good Cocktails.

True. I seriously doubt there are 3 job openings/year in a 100 mile radius of the campus for the grads. But this is rad onc, live it up while you can.

 

[RadOncMegatron]

This is kind of the issue. UCSD is a program that started in 2010/2011. Is it a good program? I don't know, maybe? I'm sure it's "fine," but if we're honest, we didn't need another program in Southern California that catered to Med Students Who Like The Beach, Craft Beer, and Good Cocktails.

From my understanding, they have a really good program. Many of the attendings are great and Dr. Mundt is truly a nice guy.

Seems like a great place to train.

Edit: Don't expect jobs in SoCal though!

 

[RickyScott]

This is kind of the issue. UCSD is a program that started in 2010/2011. Is it a good program? I don't know, maybe? I'm sure it's "fine," but if we're honest, we didn't need another program in Southern California that catered to Med Students Who Like The Beach, Craft Beer, and Good Cocktails.

Totally agree. Good program, but that is not the point.

 

[seper]

very good craft beer region indeed

 

[Doctorer]

From my understanding, they have a really good program. Many of the attendings are great and Dr. Mundt is truly a nice guy.

Seems like a great place to train.

Edit: Don't expect jobs in SoCal though!

Again, that's not the issue. There are tons of great people in our field. That doesn't mean that all of the "great" people need to start/expand programs, just so that some residents can have a great 4 years in Southern California.

 

[radonc17]

Again, that's not the issue. There are tons of great people in our field. That doesn't mean that all of the "great" people need to start/expand programs, just so that some residents can have a great 4 years in Southern California.

yup. At minimum, field should have shut down a bad program to make way for a good one (yrs ago, now we need to shut down not transfer)

now it’s bad for everyone when a good place like CCF or MDACC decreases their resident complement while bad ones are completely open for business

 

[fiji128]

yup. At minimum, field should have shut down a bad program to make way for a good one (yrs ago, now we need to shut down not transfer)

now it’s bad for everyone when a good place like CCF or MDACC decreases their resident complement while bad ones are completely open for business

Don't be fooled, those places haven't officially decreased their complements but at least they are not actively expanding.

 

[RadOncMegatron]

Again, that's not the issue. There are tons of great people in our field. That doesn't mean that all of the "great" people need to start/expand programs, just so that some residents can have a great 4 years in Southern California.

No, I agree. I am not defending the opening of more spots even at good programs.

It would be nice if the ACGME could just cancel SOAP for the academic programs for the indefinite future.

It just pisses me off that the academics get to actively ruin our field and all we can do is just sit and watch. Why should we, the vast majority of rad oncs, be powerless to allow this crap expansion.?

 

[thecarbonionangle]

The field is definitely worst off when great places cut spots while total hell pits stay open. These places will never contract out of their own volition. They “need” residents.

 

[ramsesthenice]

The field is definitely worst off when great places cut spots while total hell pits stay open. These places will never contract out of their own volition. They “need” residents.

"In North Dakota Radiation Oncology, we believe that wearing masks resident expansion is a personal decision. We leave it up to individuals programs to review the facts and decide what is right for themselves."

 

[OTN]

The field is definitely worst off when great places cut spots while total hell pits stay open. These places will never contract out of their own volition. They “need” residents.

Why?

Why does a place "need" residents? Is it truly so the academicians don't have to do all the aspects of their job? Is that really it? Are they really destroying the entire field so they don't have to dictate or contour?

I've heard several in here make it sound like it's very important to the chair that the residency program fill. Is there anything beyond "we don't want to do the work" that requires that they fill?

What would be the downside to them if all residency programs cut their spots by half?

 

[Chartreuse Wombat]

Why?

Why does a place "need" residents? Is it truly so the academicians don't have to do all the aspects of their job? Is that really it? Are they really destroying the entire field so they don't have to dictate or contour?

I've heard several in here make it sound like it's very important to the chair that the residency program fill. Is there anything beyond "we don't want to do the work" that requires that they fill?

What would be the downside to them if all residency programs cut their spots by half?

The downside is that faculty would need to do more work

 

[RickyScott]

Why?

Why does a place "need" residents? Is it truly so the academicians don't have to do all the aspects of their job? Is that really it? Are they really destroying the entire field so they don't have to dictate or contour?

I've heard several in here make it sound like it's very important to the chair that the residency program fill. Is there anything beyond "we don't want to do the work" that requires that they fill?

What would be the downside to them if all residency programs cut their spots by half?

Prestige. Publishing monkeys. Captive audience for “mentoring” and to receive your tremendous clinical wisdom. Self importance among departments-
Can Louis Potters justify 1.7 million and not have a residency program like all other departments at LIJ?

 

[Lamount]

Why?

Why does a place "need" residents? Is it truly so the academicians don't have to do all the aspects of their job? Is that really it? Are they really destroying the entire field so they don't have to dictate or contour?

I've heard several in here make it sound like it's very important to the chair that the residency program fill. Is there anything beyond "we don't want to do the work" that requires that they fill?

What would be the downside to them if all residency programs cut their spots by half?

I will not pretend there aren't MANY programs who need to contract or close down.

However, I would point out that not all programs who have opened up recently or expanded have done so for nefarious reasons, as others frequently have said.

When I was in med school, I encountered an attending who was planning to open a program (and subsequently did). It didn't strike me that he was doing this for the cheap labor, but rather that he genuinely wanted to be able to teach and have an impact on the next class of residents -like the reason many people have children. Back then, the sky was the limit for rad onc and residency expansion wasn't on many's radar -on SDN, most of the forums were of the 'do I have a chance to match?' variety. By the time the residency opened (4 years later), the tide had changed... but a lot had already been invested by the institution. I would guess this is the case at many places who have recently opened/expanded.

Regarding why chairs are desperate for their programs to fill... I couldn't say for certain, but I would guess it has something to do with the fact that there are a hoops they need to jump through to get a residency open, and not filling those spots would make them look foolish among their peers (and maybe make some in their department lose faith in their leadership). -thus it may be vanity rather than greed.

I don't know anyone training at USCD, but I can't imagine it would be impossible for them to find work -even in SoCal. Mundt is a huge name and probably won't be shy about picking up the phone... and that matters moire than a lot of other factors.

 

[thecarbonionangle]

Why?

Why does a place "need" residents? Is it truly so the academicians don't have to do all the aspects of their job? Is that really it? Are they really destroying the entire field so they don't have to dictate or contour?

I've heard several in here make it sound like it's very important to the chair that the residency program fill. Is there anything beyond "we don't want to do the work" that requires that they fill?

What would be the downside to them if all residency programs cut their spots by half?

Im not saying I agree that they truly need residents, just that they think they do. That is why departments are panicking right now.

the SOAP will be finger lickin’ good!

 

[StIGMA]

If 6 or so residents costs the department as much as 1 attending... well then it's not hard to see why you want residents.

 

[OTN]

I will not pretend there aren't MANY programs who need to contract or close down.

However, I would point out that not all programs who have opened up recently or expanded have done so for nefarious reasons, as others frequently have said.

When I was in med school, I encountered an attending who was planning to open a program (and subsequently did). It didn't strike me that he was doing this for the cheap labor, but rather that he genuinely wanted to be able to teach and have an impact on the next class of residents -like the reason many people have children. Back then, the sky was the limit for rad onc and residency expansion wasn't on many's radar -on SDN, most of the forums were of the 'do I have a chance to match?' variety. By the time the residency opened (4 years later), the tide had changed... but a lot had already been invested by the institution. I would guess this is the case at many places who have recently opened/expanded.

Regarding why chairs are desperate for their programs to fill... I couldn't say for certain, but I would guess it has something to do with the fact that there are a hoops they need to jump through to get a residency open, and not filling those spots would make them look foolish among their peers (and maybe make some in their department lose faith in their leadership). -thus it may be vanity rather than greed.

I don't know anyone training at USCD, but I can't imagine it would be impossible for them to find work -even in SoCal. Mundt is a huge name and probably won't be shy about picking up the phone... and that matters moire than a lot of other factors.

The reason why the program opened- or even how good they are today- is of little consequence. It's fine that someone wanted to help teach and have an impact on the next class of residents. However, their desire to do so and their subsequent residency program creation ended up hurting residents, and the field as a whole, in the end.

Half of all spots need to go.

Getting a radonc job in SoCal is most difficult, I have zero doubt, UCSD trainee or not.

 

[thecarbonionangle]

bottomline, the only way this gets fixed is by some serious leadership, which is pretty much a fantasy at this point. Tons of places will SOAP this year and they will fill with anybody who walks in. It is back to 1980s when just about anybody got in the field. When these graduates come out, the employment prospects will be bleak outside of “fellowships”

 

[RickyScott]

bottomline, the only way this gets fixed is by some serious leadership, which is pretty much a fantasy at this point. Tons of places will SOAP this year and they will fill with anybody who walks in. It is back to 1980s when just about anybody got in the field. When these graduates come out, the employment prospects will be bleak outside of “fellowships”

have heard that programs are ranking very marginal players, so would be surprising if there was much of a SOAP. More likely that programs will be touting diversity and life experiences of non-traditional candidates.

 

[metallica81788]

Why?

Why does a place "need" residents? Is it truly so the academicians don't have to do all the aspects of their job? Is that really it? Are they really destroying the entire field so they don't have to dictate or contour?

I've heard several in here make it sound like it's very important to the chair that the residency program fill. Is there anything beyond "we don't want to do the work" that requires that they fill?

What would be the downside to them if all residency programs cut their spots by half?

Some academic attendings are also incredibly hypocritical/contradictory.

They "need" the residents to do their, work yet complain because residents slow them down and they have to teach them. If you don't want residents, don't take a job at an academic program with residents.

I once heard "I'm not incentivized to teach" spoken directly to a resident

 

[Mandelin Rain]

Why?

Why does a place "need" residents? Is it truly so the academicians don't have to do all the aspects of their job? Is that really it? Are they really destroying the entire field so they don't have to dictate or contour?

I've heard several in here make it sound like it's very important to the chair that the residency program fill. Is there anything beyond "we don't want to do the work" that requires that they fill?

What would be the downside to them if all residency programs cut their spots by half?

Salaries go up. Hospitals/institutions don't want this, especially if they are trying to buy out satellites.. See: Hallahan.

 

[thecarbonionangle]

have heard that programs are ranking very marginal players, so would be surprising if there was much of a SOAP. More likely that programs will be touting diversity and life experiences of non-traditional candidates.

View attachment 331274

When the proud boys get out of federal, they will apply to rad onc. Have a pulse? Lukewarm body? Go right ahead and take a seat.

 

[RickyScott]

When the proud boys get out of federal, they will apply to rad onc. Have a pulse? Lukewarm body? Go right ahead and take a seat.

Will have to beat out the ghost of charlie manson

 

[communitydoc13]

Why?

Why does a place "need" residents? Is it truly so the academicians don't have to do all the aspects of their job? Is that really it? Are they really destroying the entire field so they don't have to dictate or contour?

The chairs need residents for cultural reasons too. The chairs interact with the broader institution and they need to maintain status and the appearance of a healthy and robust field. Medical oncology, ENT, Urology, Neurosurgery all notice when there are fewer radonc residents around. It gets out. This is loss of status for the chair, who at that point has professional ambitions in a completely different realm than the average working academic.

In my community practice, medonc has increased number of docs and mid-levels significantly (50%) during the same time that we have maintained relatively stable staffing levels. This was not driven by new patient referral numbers.

When I brought up how the downward pressures on radonc impact our hiring to a very nice medonc colleague, I swear I could sense the schadenfreude immediately. I'm sure academic chairs will experience this in spades.

 

[Chartreuse Wombat]

The chairs need residents for cultural reasons too. The chairs interact with the broader institution and they need to maintain status and the appearance of a healthy and robust field. Medical oncology, ENT, Urology, Neurosurgery all notice when there are fewer radonc residents around. It gets out. This is loss of status for the chair, who at that point has professional ambitions in a completely different realm than the average working academic.

In my community practice, medonc has increased number of docs and mid-levels significantly (50%) during the same time that we have maintained relatively stable staffing levels. This was not driven by new patient referral numbers.

When I brought up how the downward pressures on radonc impact our hiring to a very nice medonc colleague, I swear I could sense the schadenfreude immediately. I'm sure academic chairs will experience this in spades.

Many deans actually "grade" department chairs on how well then did as it relates to ROL and filling spots. Years ago Harvard Chair admitted in public that they always get their top choices (frequently by ignoring Match rules)

 

[kimplera]

The chairs need residents for cultural reasons too. The chairs interact with the broader institution and they need to maintain status and the appearance of a healthy and robust field. Medical oncology, ENT, Urology, Neurosurgery all notice when there are fewer radonc residents around. It gets out. This is loss of status for the chair, who at that point has professional ambitions in a completely different realm than the average working academic.

In my community practice, medonc has increased number of docs and mid-levels significantly (50%) during the same time that we have maintained relatively stable staffing levels. This was not driven by new patient referral numbers.

When I brought up how the downward pressures on radonc impact our hiring to a very nice medonc colleague, I swear I could sense the schadenfreude immediately. I'm sure academic chairs will experience this in spades.

yes - Dean's and hospital CEOs want residency slots filled. New departments have education as a goal so newly recruited chairs commit to opening residency programs. If a residency didn't fill repeatedly or residents kept failing boards this could lead to a chair being replaced by someone who would "right the ship"

 

[theradiator]

yes - Dean's and hospital CEOs want residency slots filled. New departments have education as a goal so newly recruited chairs commit to opening residency programs. If a residency didn't fill repeatedly or residents kept failing boards this could lead to a chair being replaced by someone who would "right the ship"

So how do we fix this given this toxic brew of misaligned incentives?

 

[seper]

Prestige. Publishing monkeys. Captive audience for “mentoring” and to receive your tremendous clinical wisdom. Self importance among departments-
Can Louis Potters justify 1.7 million and not have a residency program like all other departments at LIJ?

Louis is not a state employee. No way his true compensation is public )

 

[RickyScott]

Louis is not a state employee. No way his true compensation is public )

It is. Nonprofits have to list top paid employees on tax returns which you can access through guidestar. Snapshots were posted either here or on twitter.

 

[fiji128]

So how do we fix this given this toxic brew of misaligned incentives?

It won’t be fixed. Look at path as an example. Best case is that mindless expansion stops and no new programs open, which it seems it has. Hard to imagine programs will actually be contracting in a substantive way of their own volition. Existing spots can always find takers by lowering standards and if that fails finding someone desperate in the soap.

The RRC could raise standards and minimum requirements in things like brachy and peds and thus forcing a reduction of residents at places with marginal patient volumes but they have already shown there is no appetite for that.

 

[Neuronix]

Don't forget, even if not all spots fill in SOAP this year they can still fill outside the match entirely. That does not get tracked by the match and makes me a bit nervous. People will be claiming victory if some percentage of spots don't fill, then we'll come to find out later that most of those extra spots filled outside the match anyway.

 

[RadRadRad]

There are lots of problems in radonc...UCSD ain’t one of them

 

[thecarbonionangle]

There are lots of problems in radonc...UCSD ain’t one of them

I would much rather close down all hellpit programs on this thread and give the spots to UCSD. I agree. The problem is the hellpits and everyone knows who they are.

Look at a hellpit place like loma linda where the chair has hired his son and daughter!!! What a joke. When the former ASTRO president does the same thing with his son, who the f cares right? Nepotism in this specialty is so damn disgusting. The field deserves all it gets.

 

[medgator]

I would much rather close down all hellpit programs on this thread and give the spots to UCSD. I agree. The problem is the hellpits and everyone knows who they are.

They're all the problem. Anyone remember at the turn of the century when Mayo rochester and CCF only matched 2/yr? What justified them increasing spots by 50% the last decade?

 

[thecarbonionangle]

Take any hellpit place on the list, none of them are letting go of their spots unless they are taken from their cold dead fingers. nothing is ever going to change. At least Mayo and CCF are fantastic places to be.

 

[drewdog1973]

There are lots of problems in radonc...UCSD ain’t one of them

No.

you’re saying if ten programs opened up with the same or higher level of quality as UCSD that’s good? They don’t need to exist. They do and yes they are better than no good very bad trash swamp places, they still are adding to the breadlines

 

[RickyScott]

No.

you’re saying if ten programs opened up with the same or higher level of quality as UCSD that’s good? They don’t need to exist. They do and yes they are better than no good very bad trash swamp places, they still are adding to the breadlines

Agreed.

 

[RadRadRad]

No.

you’re saying if ten programs opened up with the same or higher level of quality as UCSD that’s good? They don’t need to exist. They do and yes they are better than no good very bad trash swamp places, they still are adding to the breadlines

The way to argue for residency contraction which may be fruitless) is only going to be based on something objective (Board scores/pass rate, research, etc). UCSD is in the top 50% of programs. There are programs with legitimate poor performance...these should be the targets.
And the idea that programs are just going to magically pop up with UCSD quality is unlikely. Name a program that started since them with anywhere near the same quality.

...and no I did not train or ever work at UCSD

 

[RadRadRad]

...and while we are at it, would you not prefer to be treated at UCSD over any of the other academic programs in Southern California ?