the value of a "top" program

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dl2dp2

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Since most of the rad onc residents go into private practice anyway, what's the use of a "top ranked" program? it seems like the education you get is fairly uniform across the board.

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Since most of the rad onc residents go into private practice anyway, what's the use of a "top ranked" program? it seems like the education you get is fairly uniform across the board.

Depends on your professional goals. "Top ranked" programs will usually be able to place residents in academic positions with less difficulty than middle or lower tier programs, because they have a track record of doing so.

In addition, the "pedigree" and "connection" factors will make residents at these programs more competitive for private practice jobs in highly desirable locations/situations. There are a bunch of phone calls and communications b/w your staff and these employers that you are rarely aware of, but these things can make or break your job search, so the reputation of your faculty within the field certainly makes a difference.

I guess one key thing in selecting a program is to have a sense of what your career goals are from the outset. If you know you are going to be coming back to Wewahitchka to practice, it probably doesn't matter where you train. However, if you go into the process open to any number of possibilities (private/academic/big city, etc.), then it makes sense to pursue a residency position which will leave those doors open for you.

BTW as far as actual training goes, I know that some of the "top tier" programs have taken a hit on this board for the quality of resident education, while some lesser regarded programs have received very high marks. Of course, at this point, individuals are probably about 90% of the clinicians they are going to be (for better or worse), but that is to say don't necessarily mistake "good program" for "good doctor".
 
i would like to add "and academics" to g'ville noles' statement: " In addition, the "pedigree" and "connection" factors will make residents at these programs more competitive for private practice AND ACADEMIC jobs in highly desirable locations/situations."

3 MSKCC residents 2008 - jobs at penn, u of florida, u of miami
several MDACC residents/fellows: 3 took jobs at MDACC, not sure about the rest

programs/jobs give first dibs to residents from top tier programs...this is what i found in the market this past year.


finally, the value of going to a top tier program is similar to those who go to an Ive league college or top medical school. theoretically you will be groomed in a certain way, and no-one really questions your abilities. more opportunities are available, and you leave all your options open.
 
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i think if youre talking "pedigree" that's one thing. "top" as in good is another. In that case top programs do mean better teaching and training.
 
i think if youre talking "pedigree" that's one thing. "top" as in good is another. In that case top programs do mean better teaching and training.

I agree, and tend to use the same definition. I think you'd concede, though, that "top programs" and "traditional powerhouse programs" are frequently used interchangeably on this board.

I'm not positive, but I'd have to think that employers in both academia and the private sector recognize many programs that are of middle to upper-middle pedigree turn out great clinicians (Cleveland Clinic, Fox Chase, and Beaumont come to mind. Oh yeah, Hopkins too :D), and residents in those programs are able to land good jobs.

I'm less sure about the rest of the bunch. I know there are lesser regarded programs out there with great teaching, but it's certainly conceivable that even outstanding individuals at these institutions may lose out to average individuals with good "pedigrees" in the job search, leading to a case where an ideologically "top" program gets short shrift because of poor name recognition.
 
I have a feeling pedigree matters a little less for getting a job than it does for getting a residency ... 80% of us end up in private practice. People who trained at Harvard or Michigan or Sloan or MDA are also more likely to end up in academics, so it may just seem that they are focused on pedigree.
-S
 
i think thats got an element of truth to it. but its hard to decipher. competitive programs select for competitive (ie productive) applicants to begin with. Also, those folks have access to resources to produce more in residency to make them more attractive for a job. Having said that, I agree, the pedigree becomes less important on the whole.
 
I have a feeling pedigree matters a little less for getting a job than it does for getting a residency ... 80% of us end up in private practice. People who trained at Harvard or Michigan or Sloan or MDA are also more likely to end up in academics, so it may just seem that they are focused on pedigree.
-S

i dont think this is necessarily true...i think its matter more for a job than for residency in that prospective employers can only assess/rate/value 'pedigree' (in addition to being a good fit). in private practice, they do not ask for board scores, transcripts, or research publications, etc...pedigree and gut feelings are all they have to go by.


at least in academics, they base their decision not only on pedigree and being a good fit, but also on research/grants, honors/awards, etc.

also, people tend to migrate to urban/metro areas...if this is the case, pedigree matters even more. if you are going to a location that is considered to be 'undesirable', then pedigree matters less.
 
That's a good point for the private jobs - I agree with you.

Here was my thought process about academic jobs ... If 20% of people end up in academics, and 136 residents graduate this year, then 27 people are interested in academics. If half of those come from a so called 'top program' and half are schmucks like me, that leaves about 14 peeople from top programs applying to academic positions. There is more jobs than applicants (based on ASTRO openings) and people tend to apply regionally. I'd think the programs would be in a jam if they focused too hard on applicants from top programs ...
 
Just wondering. How easy is it to find rad onc jobs? I assume by the size of the field that there would be limited openings throughout the country kind of like ophthalmology.

Also, does the equipment costs kind of limit people to certain places/employers? Or do a lot of people have their own practice?
 
That's a good point for the private jobs - I agree with you.

Here was my thought process about academic jobs ... If 20% of people end up in academics, and 136 residents graduate this year, then 27 people are interested in academics. If half of those come from a so called 'top program' and half are schmucks like me, that leaves about 14 peeople from top programs applying to academic positions. There is more jobs than applicants (based on ASTRO openings) and people tend to apply regionally. I'd think the programs would be in a jam if they focused too hard on applicants from top programs ...

it is kind of a log jam. academic programs interview top candidates early and hold off on other interviews/offers until they hear back from these top candidates. once they are out of the loop, it becomes easier to secure a job.
 
The reality is - top programs acquire the top students. The teaching may not be the best at these programs, but these are the brightest who can learn on their own, innovate, and be able to think about cases rather that just reciting standard fields.....this is quite useful in IMRT.

More importantly, people from top programs have landed in top practices - both private (ie Dosoretz) and academic. Certainly when you are job hunting a practice would kill to have a Harvard resident join them over a resident from a less well know program - you are a plus to a program like that as they can market you, and you can strengthen their program.

A great example I once heard is that there are so many JCRT and MGH alums around the country that they can get jobs that might not 'exist' on the open market.
 
Since most of the rad onc residents go into private practice anyway, what's the use of a "top ranked" program? it seems like the education you get is fairly uniform across the board.

Actually, this is a great program. If oyu are seriously thinking of P.P., you really have more choice. Certainly even PP like pedigree, but ultimately, they value great clinicians. And there are lot of programs not "top ranked" that are tops in training.
 
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