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Everyone's favorite Vinay Prasad just posted this on Twitter:
Here's the link to the article: LINK
For those who saw the thread on Twitter, he's talking about HemeOnc/Fellowships in Medicine in general, but a few of the regular anonymous RadOnc Twitter accounts joined in. There are 8 points he makes in the article on why extra fellowships are a problem - I think the points are incredibly germane to Radiation Oncology:
1) It won't stop with one year
2) Hospitals are taking the labor of fellows and money of fellows
3) Longer training keeps medicine a profession for kids of aristocrats. Some of us have to earn sooner in life.
4) More training means fewer women. Many of these fields already male-dominated.
5) Parental leave for fellows is an embarrassment.
6) The less we participate in these fellowships, the less chance they will become mandatory.
7) The alternative is training people on the job...which always happens eventually.
8) There is an irony in terms of who benefits and runs these fellowships, but did not attend them.
These eight points, I think, just succinctly nail everything that's wrong with this rise in unaccredited fellowships in RadOnc. This is personally extremely relevant to me, as a PGY-5 resident during the COVID/APM era. I have been groomed my entire career to follow an academic path. Once universities started to enact hiring freezes due to COVID, and the entire academic job market started to lock up, I asked senior faculty administration and mentors for advice. The only thing I was offered was "I guess you could do a post-doc or fellowship, it wouldn't hurt your career".
I fall squarely into point #3. I don't know if I technically meet the definition of "disadvantaged", but I was the first in my family to go to college, and am the primary income earner for my household. I have delayed getting a "real job" for many, many years, and my spouse and now kids have ridden that wave with me. I'm deep into my 30s at this point, how much more am I expected to sacrifice? Why do the people who have their jobs without doing extra training (point number 8) think recommending this to us is OK? Ironically, this advice immediately catalyzed me looking for a way out of academia.
As programs such as Moffitt's "Future of Radiation Therapy" fellowships start to materialize, how can anyone continue to argue this field is healthy? We're barrelling straight down Canada's path, where residents do cycle after cycle of fellowships, waiting for someone to retire so they can finally have a job. So maybe Moffitt is right - their fellowship is the future of RadOnc.
Here's the link to the article: LINK
For those who saw the thread on Twitter, he's talking about HemeOnc/Fellowships in Medicine in general, but a few of the regular anonymous RadOnc Twitter accounts joined in. There are 8 points he makes in the article on why extra fellowships are a problem - I think the points are incredibly germane to Radiation Oncology:
1) It won't stop with one year
2) Hospitals are taking the labor of fellows and money of fellows
3) Longer training keeps medicine a profession for kids of aristocrats. Some of us have to earn sooner in life.
4) More training means fewer women. Many of these fields already male-dominated.
5) Parental leave for fellows is an embarrassment.
6) The less we participate in these fellowships, the less chance they will become mandatory.
7) The alternative is training people on the job...which always happens eventually.
8) There is an irony in terms of who benefits and runs these fellowships, but did not attend them.
These eight points, I think, just succinctly nail everything that's wrong with this rise in unaccredited fellowships in RadOnc. This is personally extremely relevant to me, as a PGY-5 resident during the COVID/APM era. I have been groomed my entire career to follow an academic path. Once universities started to enact hiring freezes due to COVID, and the entire academic job market started to lock up, I asked senior faculty administration and mentors for advice. The only thing I was offered was "I guess you could do a post-doc or fellowship, it wouldn't hurt your career".
I fall squarely into point #3. I don't know if I technically meet the definition of "disadvantaged", but I was the first in my family to go to college, and am the primary income earner for my household. I have delayed getting a "real job" for many, many years, and my spouse and now kids have ridden that wave with me. I'm deep into my 30s at this point, how much more am I expected to sacrifice? Why do the people who have their jobs without doing extra training (point number 8) think recommending this to us is OK? Ironically, this advice immediately catalyzed me looking for a way out of academia.
As programs such as Moffitt's "Future of Radiation Therapy" fellowships start to materialize, how can anyone continue to argue this field is healthy? We're barrelling straight down Canada's path, where residents do cycle after cycle of fellowships, waiting for someone to retire so they can finally have a job. So maybe Moffitt is right - their fellowship is the future of RadOnc.