1. There's a perception among some in this thread that there's an anti-Rad Onc sentiment among us heme/oncs. This is not remotely the case in my training institution, and among the PPs in the field, close relationships with Rad Onc are highly valued. The only exception to this might be the rare PP group that acts as a total mill, herding patients into infusion chairs regardless of patient benefit or outcome. I haven't encountered any of these practices personally, but I've heard they do exist, so maybe they have colored your experiences. Regardless, you should give our field the benefit of the doubt and recognize that the vast majority of us do the right thing by our patients. Now, if the argument is that the NCCN guidelines are biased against Rad Onc, I can't comment on that, and will say that most of us will generally follow the guidelines so as to maintain SOC. But I continue to see plenty of indications for RT in the NCCN and have a strong personal preference to involve Rad Onc for my patients.
2. Med Onc should definitely be split from benign heme fellowship, and I wonder whether a non-surgical oncology residency track should be started. An IM prelim year followed by med onc + rad onc training. The question on this, though, is whether that would entail too much expertise for residents to assimilate. Perhaps not, if such a thing is already done in other countries. Thoughts?
