SOAP 2023

[RickyScott]

Radonc barely beat out em for last place.

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[Sheldor]

Radonc barely beat out em for last place.

 

[fiji128]

Just noticed the official NRMP data was posted.



For PGY-1 categorical positions. 4 programs offering 10 positions. 2 unfilled programs. 6 US MD Seniors matched with 7 total matches (3 positions not matched).

For PGY-2 advanced positions. 83 programs offering 181 positions. 24 unfilled programs. 119 US MD Seniors out of 203 total applicants. 106 US MD Seniors matched out of 147 total matches (34 positions not matched). % filled by US MDs 58.6% and total positions filled 81.2%.

SOAP:
PGY-1; 3 positions offered and 1 filled.
PGY-2; 24 positions offered and 22 filled.

Going through the data in the NRMP rad onc is definitely a match bottom dweller by just about any metric!

https://www.nrmp.org/wp-content/uploads/2023/05/2023-Main-Match-Results-and-Data-Book-FINAL.pdf

 

[sirspamalot]

Just noticed the official NRMP data was posted.



For PGY-1 categorical positions. 4 programs offering 10 positions. 2 unfilled programs. 6 US MD Seniors matched with 7 total matches (3 positions not matched).

For PGY-2 advanced positions. 83 programs offering 181 positions. 24 unfilled programs. 119 US MD Seniors out of 203 total applicants. 106 US MD Seniors matched out of 147 total matches (34 positions not matched). % filled by US MDs 58.6% and total positions filled 81.2%.

SOAP:
PGY-1; 3 positions offered and 1 filled.
PGY-2; 24 positions offered and 22 filled.

Going through the data in the NRMP rad onc is definitely a match bottom dweller by just about any metric!

https://www.nrmp.org/wp-content/uploads/2023/05/2023-Main-Match-Results-and-Data-Book-FINAL.pdf

 

[NotMattSpraker]

Just noticed the official NRMP data was posted.



For PGY-1 categorical positions. 4 programs offering 10 positions. 2 unfilled programs. 6 US MD Seniors matched with 7 total matches (3 positions not matched).

For PGY-2 advanced positions. 83 programs offering 181 positions. 24 unfilled programs. 119 US MD Seniors out of 203 total applicants. 106 US MD Seniors matched out of 147 total matches (34 positions not matched). % filled by US MDs 58.6% and total positions filled 81.2%.

SOAP:
PGY-1; 3 positions offered and 1 filled.
PGY-2; 24 positions offered and 22 filled.

Going through the data in the NRMP rad onc is definitely a match bottom dweller by just about any metric!

https://www.nrmp.org/wp-content/uploads/2023/05/2023-Main-Match-Results-and-Data-Book-FINAL.pdf

I tweeted about this last week but unsurprisingly not a lot of discussion.

This is up from last year.

ASTRO/SCAROP should be ashamed of themselves.

 

[fiji128]

I tweeted about this last week but unsurprisingly not a lot of discussion.

This is up from last year.

ASTRO/SCAROP should be ashamed of themselves.

Obviously no one at Scarop is willing to even consider reducing the number of people we are training (with the exception of harvard, mdacc and colorado). So many unnecessary training programs and residency positions. Can't even give them all away these days.

 

[NotMattSpraker]

Obviously no one at Scarop is willing to even consider reducing the number of people we are training (with the exception of harvard, mdacc and colorado). So many unnecessary training programs and residency positions. Can't even give them all away these days.

RFK Jr. told me that if you are a chair and you say the phrase "reduce training spots" you go to anti-trust jail. Or maybe someone at ASTRO told me that. Either way, just be safe out there.

 

[elementaryschooleconomics]

RFK Jr. told me that if you are a chair and you say the phrase "reduce training spots" you go to anti-trust jail. Or maybe someone at ASTRO told me that. Either way, just be safe out there.

I'm offering $100,000 to anyone who will debate Ralph about our salaries!

 

[sirspamalot]

Our specialty has been destroyed by the greed and ego of top 10 academia. Thank goodness a few of us can # it out in the rural areas free from the insanity...

 

[Ray D. Ayshun]

Our specialty has been destroyed by the greed and ego of top 10 academia. Thank goodness a few of us can # it out in the rural areas free from the insanity...

I saw some post about X "in Radiation Oncology." Doesn't matter what X is. There are any number of them. What I don't have a clue about any more is what "radiation oncology" is. I mean, I know what do, but this idea that "radiation oncology" can be talked about as a highly connected thing that will regulate itself outside if academic departments or larger practices is an myth. It's just me out here, and I feel a part of my local community, not "radiation oncology." And I'm certainly happy about that.

 

[sirspamalot]

I'm gonna go with

 

[Ray D. Ayshun]

I'm gonna go with

Do you feel like a big part of this purported "radiation oncology" community? Or that there even is one outside the academic grabassery? Point is, I generally don't know what anyone is talking about either.

 

[sirspamalot]

The community of # grows erry day. Join us....

 

[TheWallnerus]

Do you feel like a big part of this purported "radiation oncology" community? Or that there even is one outside the academic grabassery? Point is, I generally don't know what anyone is talking about either.

I totally pick up what you’re throwing down

 

[Ray D. Ayshun]

The community of # grows erry day. Join us....

Meh. Not interested in a pay cut...

 

[DebtRising]

Disgusting to see the greed of the academic establishment.

US MDs have listened and applying less.

My sincerest congratulations to all the chairs and program directors who SOAPed more souls into a field constantly and drastically reducing its role in medicine. You guys and gals are the real heroes.

 

[DebtRising]

Remember the No SOAP pledge?

2019-2020 SOAP Pledge

Alright, the supplemental "Letter to the Editor" came out yesterday with additional programs stating they would not SOAP applicants without a "demonstrated interest in Radiation Oncology". To recap, an interest in RadOnc is defined as "candidates should have participated in a 1-month clinical...

forums.studentdoctor.net

I’m sure all those who soaped, with the drastic decrease in US MDs had a “dedicated interested in radiation oncology”

My gosh there is a flawed supply and demand projection where we could already have an excess of 1600 rad oncs in the model worst case and we are mass soaping all unfilled spots. How can you look at the soul of these “academics” and not see the same cold calculation as an insurance executive. So ashamed to be part of this.

 

[thecarbonionangle]

The amount of warm body filling hellpits is disgusting. Quietly hellpit chairs and their buddies filled their programs and will continue to do so. There is zero hope to rectify this in my view.

 

[ramsesthenice]

Spots are not going unfilled. I have talked to a couple younger chairs who didn’t plan to SOAP. Then their VPMAs gave veiled threats about never having to go unmatched before ☹️

The chest thumping goes higher than us.

 

[fiji128]

Spots are not going unfilled. I have talked to a couple younger chairs who didn’t plan to SOAP. Then their VPMAs gave veiled threats about never having to go unmatched before ☹️

The chest thumping goes higher than us.

I have written and catalogued on here for years about what happens with these training spots. This idea that somehow if we don't fill spots in the initial match that things will self correct has been suspect since it was first proposed by the "academics." Not sure why this constantly get repeated at this point. Most spots that don't fill in the initial match will get filled in the SOAP. Those that are left over after that will just be offered the following year in the regular match or outside of the match. Training spots do not go unfilled/unused in the long run.

All the evidence over the past 10 years shows the only way to reduce spots is to permanently close programs. The specialty has tons of unnecessary programs that offer subpar training where residents are used as free/cheap labor and serve no other purpose then that.

Programs that have closed with approved resident spots prior to withdrawal of accreditation; Drexel in 2019 (4), Medical College of Georgia in 2019 (4), California Pacific in 2019 (4) Cornell 2021 (6) and NCI in 2023 (6). From 2022 to 2023 MDACC officially decreased it's total training compliment from 28 to 24 (only program to have done so). So that is a total of 28 spots that are gone forever and can't be filled or 7 per year.

Programs to have officially increased spots from 2019 to 2021; Loma Linda 5 to 6, Case Western Reserve 6 to 7, Columbia 6 to 8, Northwestern 8 to 9, Thomas Jefferson 9 to 11, Duke 13 to 14. No increases since 2021. So that is a total of 9 spots that are likely with us for a very long time or about 2 per year.

So since 2019 the specialty has net contracted 19 total training spots or about 5 per year.

The math speaks for itself. Which is why only 109 US MD seniors are electing to pursue this as a career choice after med school.

 

[DebtRising]

Yep, even Dan Spratt - who is a pretty cool dude - came in and gas lit us about this topic.

At least we have saved US MDs from being taken advantage of to some extent.

But I am surprised that literally all programs soaped. No way all those applicants had oncology interest. Shows to a person the leadership of this field does not care about the next generation. That no one at all cares surprises me, even acknowledging the last 10 years.

 

[medgator]

With the mismatch of residency spot numbers which have been relatively stagnant vs explosive growth in DO and for profit med schools the last several years, every spot will get filled, as some medical students simply go unmatched in anything now.

 

[fiji128]

With the mismatch of residency spot numbers which have been relatively stagnant vs explosive growth in DO and for profit med schools the last several years, every spot will get filled, as some medical students simply go unmatched in anything now.

The key number to watch is total number of US MD Senior that match.

 

[Chartreuse Wombat]

The key number to watch is total number of US MD Senior that match.

Exactly. Peak RadOnc 200 US Seniors. Currently 100-120 US Seniors.

 

[ramsesthenice]

Which is why only 109 US MD seniors are electing to pursue this as a career choice after med school.

In context, it makes sense, but man is it hard to believe. I discovered the field by accident 20 years ago when I met the rad onc at a small regional hospital near where I went to school. I was already interested in cancer and knew this was where I wanted to be. Which meant I knew I had to be the best of the best all the way through training to get a good spot.

Then again, we all still tried to get to Blockbuster early on Friday to make sure we could get a copy of the new releases back then too. I guess some titans have faired worse than us

 

[RickyScott]

In context, it makes sense, but man is it hard to believe. I discovered the field by accident 20 years ago when I met the rad onc at a small regional hospital near where I went to school. I was already interested in cancer and knew this was where I wanted to be. Which meant I knew I had to be the best of the best all the way through training to get a good spot.

Then again, we all still tried to get to Blockbuster early on Friday to make sure we could get a copy of the new releases back then too. I guess some titans have faired worse than us

I am so curious how any medstudent could think radonc would be safe (in terms of a job) for the next 40 years. Seems incredibly bad judgement and not someone I would ever want treating my family.

When I was a ms3 the future of cancer was supposedly genetic eng and angiogenesis. Chemo had almost no appreciable os effect in most stage 4 cancers, and the notion of immune system in cancer was fringe. And I still had some concerns despite no twitter or Sdn.

 

[Mandelin Rain]

I am so curious how any medstudent could think radonc would be safe (in terms of a job) for the next 40 years.

No one tells them different.

I'm worried about making it another 15 years.

 

[ramsesthenice]

I am so curious how any medstudent could think radonc would be safe (in terms of a job) for the next 40 years. Seems incredibly bad judgement and not someone I would ever want treating my family.

How well do you remember your medical school class? Of all the lessons I learned, the scariest was realizing there is literally no correlation between good test scores and common sense.

 

[RickyScott]

How well do you remember your medical school class? Of all the lessons I learned, the scariest was realizing there is literally no correlation between good test scores and common sense.

Very well because I really busted my ass. There were some people like that but they were the exception. For the most part, the guys at the top of the class were almost always highly capable (Dan spratt types) and not just book smart.

 

[sirspamalot]

The quiet polite women were the smartest (grade wise).

Define success after graduation: academic accomplishment? most money? most prestigious training program / specialty?

Meh

 

[TheWallnerus]

In context, it makes sense, but man is it hard to believe. I discovered the field by accident 20 years ago when I met the rad onc at a small regional hospital near where I went to school. I was already interested in cancer and knew this was where I wanted to be. Which meant I knew I had to be the best of the best all the way through training to get a good spot.

Then again, we all still tried to get to Blockbuster early on Friday to make sure we could get a copy of the new releases back then too. I guess some titans have faired worse than us

Blockbuster:hot businesses::Rad onc:hot residencies

Once you see it you can't unsee it

 

[RickyScott]

The quiet polite women were the smartest (grade wise).

Define success after graduation: academic accomplishment? most money? most prestigious training program / specialty?

Meh

Guys- I meant to include girls as well. Success- you know it when you see it, whether private practice or academics. Many, but not all, went into academics.

 

[TheWallnerus]

For the most part, the guys at the top of the class were almost always highly capable (Dan spratt types) and not just book smart.

I mean... Dan is a chair. A young chair. He seems super weirdly driven in other areas too. So I get what you're saying.

But presently, if you choose rad onc as a career path, how "highly capable" can you really be? You're sure not going to, more than likely, wind up changing the trajectory of oncology like a Craig Jordan or Dennis Slamon. You're not likely at all to wind up being a dean or president. You're instead at high risk of winding up in academic satellite for many years being arguably underemployed and certainly underpaid versus same such peers in same such jobs ~20 years ago. Rad onc is over-supplied both in people and equipment/technology, its utilization footprint has been creeping downward for decades, many of the cancers we commonly treat are getting less common, and many non-rad onc treatments seem poised to reduce the rad onc footprint even further.

I heard another rad onc recently say re: current rad onc chairs, "He may, deep down, realize he's the king, but king of S**t Mountain." The *truly* highly capable people to which you're referring... and we both know "the type" very well... I just don't think they're choosing rad onc now.

 

[thecarbonionangle]

DS came on here and suggested a new era for rad onc “leadership”, yet when it came time to show this, the program quietly filled. Ain’t it funny how that is! There is no other option than to shut down all these hellpits.

 

[fiji128]

DS came on here and suggested a new era for rad onc “leadership”, yet when it came time to show this, the program quietly filled. Ain’t it funny how that is! There is no other option than to shut down all these hellpits.

This is why it is important to catalogue on here what happens with the match and the training spots for all to see. Otherwise you would just be left with the meaningless rhetoric from the various chairs/PDs talking about how amazing all the applicants are and how bright the future is for everyone.

 

[RickyScott]

I mean... Dan is a chair. A young chair. He seems super weirdly driven in other areas too. So I get what you're saying.

But presently, if you choose rad onc as a career path, how "highly capable" can you really be? You're sure not going to, more than likely, wind up changing the trajectory of oncology like a Craig Jordan or Dennis Slamon. You're not likely at all to wind up being a dean or president. You're instead at high risk of winding up in academic satellite for many years being arguably underemployed and certainly underpaid versus same such peers in same such jobs ~20 years ago. Rad onc is over-supplied both in people and equipment/technology, its utilization footprint has been creeping downward for decades, many of the cancers we commonly treat are getting less common, and many non-rad onc treatments seem poised to reduce the rad onc footprint even further.

I heard another rad onc recently say re: current rad onc chairs, "He may, deep down, realize he's the king, but king of S**t Mountain." The *truly* highly capable people to which you're referring... and we both know "the type" very well... I just don't think they're choosing rad onc now.

no doubt we are losing out on top people, but I am concerned abt the average applicant. The poor judgement inherent in selecting radonc is a real issue that we have to confront and not sweep under the rug. When it comes to one of the most important decisions in life, who looks around (and yes that includes social media) and concludes that employment in radiation is really promising for the next 40 yrs. Would you want someone with such poor judgement treating a family member?

Who would you want as your radonc - an applicant who carefully evaluated the state of the specialty and now feels it has a great future. vs someone who barely passed med school due to drug/criminal/mental issues and grabbed whatever they could get into, but is now on the straight and narrow?

 

[sirspamalot]

no doubt we are losing out on top people, but I am concerned abt the average applicant. The poor judgement inherent in selecting radonc is a real issue that we have to confront and not sweep under the rug. When it comes to one of the most important decisions in life, who looks around (and yes that includes social media) and concludes that radiation is a sure bet as a job for the next 40 yrs. Would you want someone with this kind of judgement treating a family member.

Who would you want as your radonc - an applicant who carefully evaluated the state of the specialty and now feels it has a great future. vs someone who barely passed med school due to drug/criminal/mental issues and grabbed whatever they could get into, but is now on the straight and narrow?

Basically if you aren't going to MDAH, MSK, or maybe a couple other programs, I don't even know why you'd go into the field. There is zero room to be at anything other than a 1A program.. and even that is pretty damned iffy at this point.

 

[salubalu]

Basically if you aren't going to MDAH, MSK, or maybe a couple other programs, I don't even know why you'd go into the field. There is zero room to be at anything other than a 1A program.. and even that is pretty damned iffy at this point.

I wonder what percent of these docs are going into work in centers that are not in the top 20 biggest cities in the US. Rest of America needs rad oncs too.

 

[RickyScott]

Basically if you aren't going to MDAH, MSK, or maybe a couple other programs, I don't even know why you'd go into the field. There is zero room to be at anything other than a 1A program.. and even that is pretty damned iffy at this point.

The name only helps land your 1st job (probably at some satellite) and then you are largely on your own. The idea that today a doc is set for life after landing a 1st job is common, and quite laughable. (Maybe 15 yrs ago with sero, Princeton group, and that’s why xrt was competitive ) Everyone needs raises, promotions, advancements for career satisfaction, which largely depend on a healthy job market. Down the line, no one is going to advance you because you were once a resident at mskcc.

 

[sirspamalot]

That is correct especially in private practice where social skillz (and/or brownnosing) can make or break you.

I was thinking more along the lines of getting into academia as at least it would be a) in a major city and b) stable.

But the truly gifted? Well..

Only a select few are good enough.. the few, the proud.... #

 

[RickyScott]

That is correct especially in private practice where social skillz (and/or brownnosing) can make or break you.

I was thinking more along the lines of getting into academia as at least it would be a) in a major city and b) stable.

But the truly gifted? Well..

Only a select few are good enough.. the few, the proud.... #

Even in academics, it can be hard to get a substantial raise unless you have viable offer to leave.

 

[fiji128]

I wonder what percent of these docs are going into work in centers that are not in the top 20 biggest cities in the US. Rest of America needs rad oncs too.

3/4 of the rad oncs at this clinic in rural Santa Barbara are from Harvard.

Healthcare Providers | Ridley-Tree Cancer Center

Find a doctor in the cancer specialty you want who is accepting new patients at Ridley-Tree Cancer Center.

www.ridleytreecc.org

 

[Ray D. Ayshun]

3/4 of the rad oncs at this clinic in rural Santa Barbara are from Harvard.

Healthcare Providers | Ridley-Tree Cancer Center

Find a doctor in the cancer specialty you want who is accepting new patients at Ridley-Tree Cancer Center.

www.ridleytreecc.org

Well, Harvard is known for producing docs whose mission it is to serve the underserved...

Edit: thanks for the setup there, Fiji

 

[NotMattSpraker]

DS came on here and suggested a new era for rad onc “leadership”, yet when it came time to show this, the program quietly filled. Ain’t it funny how that is! There is no other option than to shut down all these hellpits.

This is the most depressing thing to me because I used to be hopeful things would change once a new generation of leaders took the reigns.

The fact is, our approach to talking about the RO workforce is so pathologic that I worry everything surrounding this topic is beyond repair. Most developed countries monitor and regulate the medical workforce while our largest society threatens people with lawyers for even talking about it.

We got a work force study, presumably to address the ever louder concerns, but the committee was openly unscientific in creating their model. Regardless, if anything, the model definitely shows uncertainty about supply and demand with a chance of oversupply well within error, and of course this has not been communicated to prospective applicants and ASTRO has made no recommendations with the results. Because, allegedly, this would be illegal.

Im left wondering if anyone even wants to change anything, or if these grumpy letters in IJROBP are just another pub on the CV.

I have great respect for the few dedicated people that seem to continue to engage the crazy on these issues. I would never be able to do it. I'm also thankful to SDN for providing important context when in the future people are wondering how we got to the troubling place we seem to be heading.

 

[RickyScott]

The name only helps land your 1st job (probably at some satellite) and then you are largely on your own. The idea that today a doc is set for life after landing a 1st job is common, and quite laughable. (Maybe 15 yrs ago with sero, Princeton group, and that’s why xrt was competitive ) Everyone needs raises, promotions, advancements for career satisfaction, which largely depend on a healthy job market. Down the line, no one is going to advance you because you were once a resident at mskcc.

I remember at Astro when I was a resident, adam raben ( a lot of radoncs in that family) showing a slide of exposed breasts and likening the first job contract to first time (seeing this) and cautioning that we will have long career ahead of us, that the game is far from over. I am sure he would be cancelled for this today.

 

[Fpg1245]

I remember at Astro when I was a resident, adam raben showing a slide of exposed breasts and likening the first job contract to first time (seeing this) and cautioning that we will have long career ahead of us, that the game is far from over. I am sure he would be cancelled for this today.

If that’s the case then I got the saddest droopiest ones of all.

 

[Chartreuse Wombat]

ASTRO "worries about anti-trust" but there is this

SCAROP Financial Survey - American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

Learn about the 2021 SCAROP Financial Survey's background, participating institutions and purchasing instruction.

www.astro.org

The confidential data primarily represents radiation oncology departments from United States medical schools.

The final report is made available for purchase by SCAROP members only.

No collusion here..move along

 

[Lamount]

I mean... Dan is a chair. A young chair. He seems super weirdly driven in other areas too. So I get what you're saying.

But presently, if you choose rad onc as a career path, how "highly capable" can you really be? You're sure not going to, more than likely, wind up changing the trajectory of oncology like a Craig Jordan or Dennis Slamon. You're not likely at all to wind up being a dean or president. You're instead at high risk of winding up in academic satellite for many years being arguably underemployed and certainly underpaid versus same such peers in same such jobs ~20 years ago. Rad onc is over-supplied both in people and equipment/technology, its utilization footprint has been creeping downward for decades, many of the cancers we commonly treat are getting less common, and many non-rad onc treatments seem poised to reduce the rad onc footprint even further.

I heard another rad onc recently say re: current rad onc chairs, "He may, deep down, realize he's the king, but king of S**t Mountain." The *truly* highly capable people to which you're referring... and we both know "the type" very well... I just don't think they're choosing rad onc now.

To be fair, it's hard to "change the trajectory" of oncology as a med/onc as well, unless you work for pharma -in which case, your contributions will be anonymous anyway.

 

[thecarbonionangle]

ASTRO "worries about anti-trust" but there is this

SCAROP Financial Survey - American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

Learn about the 2021 SCAROP Financial Survey's background, participating institutions and purchasing instruction.

www.astro.org

The confidential data primarily represents radiation oncology departments from United States medical schools.

The final report is made available for purchase by SCAROP members only.

No collusion here..move along

BEAUTIFUL report, NO COLLUSION!

 

[RickyScott]

ASTRO "worries about anti-trust" but there is this

SCAROP Financial Survey - American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

Learn about the 2021 SCAROP Financial Survey's background, participating institutions and purchasing instruction.

www.astro.org

The confidential data primarily represents radiation oncology departments from United States medical schools.

The final report is made available for purchase by SCAROP members only.

No collusion here..move along

As they now represent the majority of employers of new grads, how is this not collusion? If anyone wants to crowdsource suing Astro, no better use for earmarked dues . Would love to put Astro scarop etc through discovery.