The Influence of Online Forums on Radiation Oncology Residency Program Selection

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Members don't see this ad.
Neuronix said:
Some big talkers here. Step up to your chairs or referrings as faculty or in practice and see what happens to you.
Click to expand...

Whats up

259891
 
Neuronix said:
Some big talkers here. Step up to your chairs or referrings as faculty or in practice and see what happens to you.
Click to expand...
A radiation oncologist and his surgeon friend were driving, rapidly probably, when a state trooper pulled the pair over for speeding. The surgeon was driving. The trooper, large, ominous, wearing dark shades, slowly walked to the driver side of the car, tapped on the window with his nightstick, and motioned for the surgeon to roll down the window. He did. "License and registration please." The trooper looked it over for a second and then WHACK without warning hits the surgeon on the head. Hard. "OW!" said the surgeon. The trooper then walked around the back of the car to the passenger side where the rad onc was sitting. He motioned for the window to be rolled down and said "Let me see your license son." The rad onc handed him his license. He looked it over for a bit and then WHACK! hit the rad onc in the head with his nightstick. The rad onc said "Hey what'd you do that for?!" The trooper said, "I'm just making your wish come true son." "What do you mean by that??" "Well after I hit your buddy, and if I would have let you go, you woulda got a few miles down the road and then said 'I wish that S.O.B. would've tried hittin' me.'"
 
It's sad to see the red journal essentially being used as a propaganda outlet to defend leadership in our field (even if the authors didn't intend that). It's pretty clear why they accepted this article, despite the obvious weaknesses. Sure, the reason that many spots went unfilled was due to SDN and not because of rampant, unchecked residency expansion. Does any other field write articles about how online forums are the major cause of that field's problems? I mean, come on.
 
levels said:
It's sad to see the red journal essentially being used as a propaganda outlet to defend leadership in our field (even if the authors didn't intend that). It's pretty clear why they accepted this article, despite the obvious weaknesses. Sure, the reason that many spots went unfilled was due to SDN and not because of rampant, unchecked residency expansion. Does any other field write articles about how online forums are the major cause of that field's problems? I mean, come on.
Click to expand...

What submissions did they reject in favor of this tripe?
 
I agree with the criticism of this paper conflating the google spreadsheet with the SDN forum (although it could be argued that the google spreadsheet evolved from the SDN forum and many applicants find the spreadsheet through postings on the forum).

However, when I read the manuscript my interpretation was that the authors were arguing that the forum is influential (I agree with this conclusion) and suggesting training programs should interact directly with the forum. This would allow residencies to provide a direct source of information about their programs to applicants and would also provide a means of feedback to improve the training programs. This did not seem like an inflammatory suggestion to me. Increased engagement would hopefully benefit all parties.
 
bobloblaw said:
I agree with the criticism of this paper conflating the google spreadsheet with the SDN forum (although it could be argued that the google spreadsheet evolved from the SDN forum and many applicants find the spreadsheet through postings on the forum).

However, when I read the manuscript my interpretation was that the authors were arguing that the forum is influential (I agree with this conclusion) and suggesting training programs should interact directly with the forum. This would allow residencies to provide a direct source of information about their programs to applicants and would also provide a means of feedback to improve the training programs. This did not seem like an inflammatory suggestion to me. Increased engagement would hopefully benefit all parties.
Click to expand...

They are free to promote their own program. I just think it’s a stealthy way for them to encourage their PDs and faculty to flood the forum with rosy propaganda.
 
Instead of (re-)merging with radiology like Lord Paul, House of Wallner, suggested ("Whither Thou Goest, I Will Go"), radiation oncology should merge with psychiatry. Why? Because thinking this forum "ruined" the field is delusional. It would be as silly as saying the spiciness of the kimchi ruined the North Korean denuclearization talks. You can take a short walk anywhere outside the confines of SDN to smell that radiation oncology emanates if not the odor of c. perfringens, at least p. aeruginosa (gratuitous med student humor).

Here's an article in press at the Red Journal. Would a female be excited about rad onc after reading it?* I'm not a woman, nor can I think like one, but even so. "These problems are surmountable," one might say. You know what's even better? Avoiding problems in the first place. If I were a carpenter, I know what I'd do; if I were a med student again, I know what I'd do, too.

*
Of 170 female residents surveyed, 125 responded (74% response rate). Over one-quarter were in programs with ≤2 female residents (29%) and ≤2 female attendings (29%). A third (34%) reported having children. Over half (51%) reported that lack of mentorship affected career ambitions. Over half (52%) agreed that gender-specific bias existed in their programs, and over a quarter (27%) reported they had experienced unwanted sexual comments, attention or advances by a superior or colleague. Only 5% reported no symptoms of burnout. Almost all (95%) agreed that radiation oncology is perceived as family-friendly, however only 52% agreed that it actually is. An overwhelming majority (90%) expressed interest in joining a professional group for women in radiation oncology
Click to expand...
 
scarbrtj said:
Instead of (re-)merging with radiology like Lord Paul, House of Wallner, suggested ("Whither Thou Goest, I Will Go"), radiation oncology should merge with psychiatry. Why? Because thinking this forum "ruined" the field is delusional. It would be as silly as saying the spiciness of the kimchi ruined the North Korean denuclearization talks. You can take a short walk anywhere outside the confines of SDN to smell that radiation oncology emanates if not the odor of c. perfringens, at least p. aeruginosa (gratuitous med student humor).

Here's an article in press at the Red Journal. Would a female be excited about rad onc after reading it?* I'm not a woman, nor can I think like one, but even so. "These problems are surmountable," one might say. You know what's even better? Avoiding problems in the first place. If I were a carpenter, I know what I'd do; if I were a med student again, I know what I'd do, too.
Click to expand...

Did we even need to look at the article to know exactly what it is going to say and who wrote it?

I think this article shows why this online forum has some influence as "the real stuff" and not only the ASTRO approved opinions are allowed to be spoken here. Of course, there are exceptions like Dr. Amdur and the Univ of Florida crew, as well as Dr. Tepper.
 
I can't imagine too many more family friendly fields of medicine. Man or woman. If you can't handle the 7:30-4:00 with minimal call rigors of radiation oncology, medicine in general may just not be for you.
 
Nice job you have there. I don't think I've ever finished at 4 PM.

Depending on clinic, inpatients, and how busy the machines are, 7 PM is typical in my experience including tumor boards and other meetings. If a machine breaks or volume (clinic, inpatient, or machine) is unexpectedly high, later than that for days, weeks, or even months in a row is not that unusual.

One of the jokes that one of the very senior attendings made when I started was "They told me this would be a 9-5 job. Turns out I didn't hear right, it was really 5-9!" While that's an exaggeration, I'm not exaggerating when I say I typically see the neurosurgeon attendings in the parking lot both when I come in and leave. Of course they have nicer cars than me, but we'll ignore that :laugh:

I could leave earlier if I did my notes at home instead and did no research. I'm in academics and I'd like to actually get ahead/promoted someday. if I stopped doing research, I'd have to be in clinic 4 days a week instead across multiple centers and catch up on the fifth day, so it'd be a 50-60 hour a week clinical job at academic pay instead of a 50-60 hour a week academic job.

Is that family friendly? I guess you can be the judge. When they expect you to stay until the machine finishes and/or expect you to see all the inpatient consults at the end of the day and the time you finish can be highly variable based on the day, it can be very hard to schedule things like picking up kids from daycare or sitting down to dinner with the family.
 
Neuronix said:
Nice job you have there. I don't think I've ever finished at 4 PM.

Depending on clinic, inpatients, and how busy the machines are, 7 PM is typical in my experience including tumor boards and other meetings. If a machine breaks or volume (clinic, inpatient, or machine) is unexpectedly high, later than that for days, weeks, or even months in a row is not that unusual.

One of the jokes that one of the very senior attendings made when I started was "They told me this would be a 9-5 job. Turns out I didn't hear right, it was really 5-9!" While that's an exaggeration, I'm not exaggerating when I say I typically see the neurosurgeon attendings in the parking lot both when I come in and leave. Of course they have nicer cars than me, but we'll ignore that :laugh:

I could leave earlier if I did my notes at home instead and did no research. I'm in academics and I'd like to actually get ahead/promoted someday. if I stopped doing research, I'd have to be in clinic 4 days a week instead across multiple centers and catch up on the fifth day, so it'd be a 50-60 hour a week clinical job at academic pay instead of a 50-60 hour a week academic job.

Is that family friendly? I guess you can be the judge. When they expect you to stay until the machine finishes and/or expect you to see all the inpatient consults at the end of the day and the time you finish can be highly variable based on the day, it can be very hard to schedule things like picking up kids from daycare or sitting down to dinner with the family.
Click to expand...
I mean, it sounds more like you have a lousy job than I have a nice job. I'd guess 8.5-9.5 hour days is pretty standard in Rad Onc, including tumor boards, etc... My academic attendings during residency were routinely rocking 6-7 hour days while we did the scut. Granted, I'm not writing manuscripts in hopes of advancement, but that's part of what you sign up for when choosing an academic career.

There aren't many fields of medicine that don't stay late if there are a lot of sick people to care for or have to go see really sick people in the hospital after a clinic day. My guess is these things happen to us much less than most specialties.

The supervision requirement is the least family friendly portion of rad onc, in so much that it's hard to come late/leave early/mid day break. I miss Donuts with Dad every year, but I'm home for dinner/practice/games like 90% of the time.
 
Mandelin Rain said:
I mean, it sounds more like you have a lousy job than I have a nice job. I'd guess 8.5-9.5 hour days is pretty standard in Rad Onc, including tumor boards, etc... My academic attendings during residency were routinely rocking 6-7 hour days while we did the scut. Granted, I'm not writing manuscripts in hopes of advancement, but that's part of what you sign up for when choosing an academic career.
Click to expand...

I don't feel like I did or do have a choice. When I applied for residency, I applied all over the country and matched in the middle of my rank list at a place I had never previously heard of in a region I had never previously been to. When I was a resident, I applied all over the country including PP and academics. This is the position I managed to get. I had one other job offer in another hospital based academic satellite several thousand miles away. I know who took that job (after a fellowship--fortunately I didn't have to do one of those) and they are just as busy as I am. That was a few years ago when I graduated. I feel fortunate to be employed, and I hope that I don't lose this job since I know residents graduating now who have no permanent position.

That written, my job isn't all bad, and I think I'm very good at what I do. It's just that family friendly is not how I'd describe my position. I know several women in this specialty who would agree that radiation oncology is not family friendly for them due to the poor job market with lack of location flexibility or negotiating power as well as the issues with long and/or inconsistent work hours that I just described.

There aren't many fields of medicine that don't stay late if there are a lot of sick people to care for or have to go see really sick people in the hospital after a clinic day. My guess is these things happen to us much less than most specialties.
Click to expand...

I mean grass is always greener and all, but the med oncs I know have very clear inpatient duties a few weeks a year. I know several med oncs who are 100% outpatient. They don't get hit with inpatients tacked on at the end of busy clinics. When their clinics end, they're done. There are no machines to babysit. Their job market is also reasonable, so if they're unhappy they can easily move around. I have similar thoughts for radiology. I'm not going to switch medical specialties now, but these are definitely things to consider for medical students and it's no surprise to me that many residents don't consider this specialty family friendly.

I miss Donuts with Dad every year, but I'm home for dinner/practice/games like 90% of the time.
Click to expand...

My kids are too young for this, but my wife is VERY concerned about this in the future given my work hours. When I'm on call I usually have to come in on the weekends, but at least our group is big enough that I don't have to take much call. So I don't do much on the weekend outside of academics or catching up on clinical stuff. That is a nice perk, though common to outpatient specialties. The inpatient specialties are moving to things like 7on/7off which has its own pros and cons I suppose.
 
Definitely a bummer hearing people struggle so much to find A job, and when they do they're worried about getting home to see their kids.

The start to my job was similar, I guess. We had some staffing disruptions and I was treating way more patients that I wanted. Working 7-7 routinely for about a year. Had enough and eventually issued an ultimatum. Money was nice, but life is too short. Worked out great and I got back into a much more normal schedule with a much more normal patient load now for many years. I always viewed that as a short term disruption due to some isolated events, but I suppose had I not advocated for myself, it could have been my life.
 
Mandelin Rain said:
I suppose had I not advocated for myself, it could have been my life.
Click to expand...

I imagine the job market was better back then. The only way I've seen is to negotiate is with another offer. Those are in very short supply nowadays.

scarbrtj said:
Hey, dudes!... pretty depressing stories. You're ruining the narrative. If not the field :/
Click to expand...

:laugh: Please don't ever leave. Your posts are hilarious.
 
Chartreuse Wombat said:
Excellent! Good luck!
Click to expand...

The SDN response to the article has been accepted for publication.

Don't expect anything juicy--I just wrote it to state basically that the spreadsheet was made entirely without the input or control of SDN and that SDN is not affiliated with it.

Also, as always, SDN is an open space to discuss the specialty. We are proud of our tradition in helping students become doctors.
 
Old rad onc said:
The day is coming when those in the ivory tower will realize they will have created their own monster. I do notice the 10 centers that were given 3x to 4x for all cancer treatments are expanding their satellite offices at a rapid rate. Controlling the market is the primary goal. As we have predicted the assault on Radiation Oncology through overtraining and expansion, it is not a surprise to see finger pointing and flimsy argumented excuses. Those in private practice will need to prepare for the future arguments from ASTRO which I predict will include: Academic centers and large groups have superior treatment and reimbursement will be tied to its involvement which may be controlled by center certification overseen by “Leaders “ in our field. The saturation of jobs is not more than 5- 7 years away. I feel badly for those starting residency. ASTRO and the red journal need to come up with innovations in imaging and patient/tumor accuracy. Protons is not the answer. As targeted therapy improves, local therapy becomes more important . Rad Onc SDN has been focused on saving our field. This desperate move only gives further credence to the argument that the disconnect from the PD’s and Chairs is Cavernous. Time for some of the smart ones to show some courage. Truth or more heads in the sand. You choose, change or a bigger House of Cards?
Click to expand...

This post nails it. When chairs or other leaders argue about anti-trust issues, what people fail to understand is that the person making that argument is insinuating that she/he will raise these issues should her/his bottom line take a hit. It has nothing to do with a government official overseeing whether some small, no-name, field decides they have enough radiation oncologists. The chairs have effectively engaged in backroom agreements to maximize the supply of radiation oncologists.
 
sphinx2019 said:
This post nails it. When chairs or other leaders argue about anti-trust issues, what people fail to understand is that the person making that argument is insinuating that she/he will raise these issues should her/his bottom line take a hit. It has nothing to do with a government official overseeing whether some small, no-name, field decides they have enough radiation oncologists. The chairs have effectively engaged in backroom agreements to maximize the supply of radiation oncologists.
Click to expand...

The argument was always a very flimsy and transparent one. Honestly most chairs and PDs and either totally out to lunch or so self serving they can’t keep the lies straight.
 
Well these days seems like Zeitman is wiling to bless all sorts of TRASH survey research with response rates at the level of a septic system. You guys smell that?:clown::clown:
 
rad0nccc said:
Conspicuous silence from the guy who stood up at ASTRO and opined that medical students would be the “canaries in the coal mine” for residency expansion by abandoning the specialty ... now that his exact prediction came to pass in last year’s match. Expect more leadership from the editor of the Red Journal.
Click to expand...

The british “leading”? Rubbish!!!
 
In case anyone on SDN is eloquent:

The next Red Journal special edition will address a subject of red hot research with real practice-changing implications. This is the interaction between radiation therapy and the immune response. We are looking for cutting-edge studies from the clinic or the lab, comprehensive review articles, and eloquent opinion pieces.
Click to expand...
 
It's funny, I actually don't disagree with the two-sentence conclusion in the article. But, yes, I'm surprised that Red Journal published something like this.
 
You must log in or register to reply here.

Similar threads

Gfunk6
The problems facing radiation oncology
Replies
30
Views
4K
evilbooyaa
evilbooyaa
D
Radiation oncology vs. radiation medicine
Replies
9
Views
2K
joeshmo27
J
RadOncMegatron
Best Radiation Oncology Books
Replies
19
Views
4K
IonsAreOurFuture
I
RadOnc2019
Radiation Oncology Oral Boards 2025
Replies
0
Views
2K
RadOnc2019
RadOnc2019
D
Benzos in Radiation Oncology
Replies
13
Views
2K
evilbooyaa
evilbooyaa
Top