VVPN Livestream 7PM EST, "What Did We Learn from 2021 Match?"

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Oh my God, SIMUL FROM THE TOP ROPE

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elementaryschooleconomics said:
PINNIX FROM THE TOP ROPE

"[There's this perception that] now that there's no interest in RadOnc, this is now an opportunity for Black physicians, Hispanic physicians, women physicians..."
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[TRANSLATION]

Now that Whitey has sucked Rad Onc dry and rendered it into a lifeless, desiccated husk, let's bring minorities on board! If we are all going to be miserable and jobless, we should be diverse, miserable and jobless.
 
I like how he was like when I was applying (with half the number of residents), it was (still) competitive. By the way I’m a chair now.
 
CurbYourExpectations said:
LP is a multimillionaire, making almost 2mil a year apparently, living in the most competitive market in the US and saying "job market is fine, I had a tough job market too." while being in a leadership position telling 1000 bunnies who will never have close to the opportunities he has this. This is either funny or sad. Kind of gives me a sad feeling though. Wonder what his opinion would be if he was coming out of bunny boot camp soon with the current trend.
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BK mentioned he's a sailor also... Must have a nice yacht
 
nice opening salvo by parikh, but otherwise mostly meh excepting pretty much everything I saw Royce say that accurately summed up the situation in which we find ourselves. What was Simul's background btw?
 
TheWallnerus said:
The lamest moment of night was the moment when Potters went on about the need for internet posters to be non-anonymous. And I know lame!

- Tiny Tim Cratchit
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Close second were 1) “let’s not worry about fractions and get back to treating patients” 2) trash about exposing more medstudents to radonc to drum up interest (and the amazing work Dan Golden has done) because fear of physics is the real issue.
 
Finally got to watch Simul’s segment, and good God you all weren’t kidding. Pulled precisely zero punches. ASTRO left me / is this is elementary school / piss on our leg and tell us it’s raining - what a triumvirate.

I’m so glad he’s out there fighting for our viewpoint. He’s doing an amazing job. Simul the Great indeed!
 
radonc17 said:
YES! Dr. Pinnix vocalized very eloquently what we have hinted at on here.

Truly POWERFUL

Also, I just want to give a big hug to simul and trevor right now. king moments
elementaryschooleconomics said:
PINNIX FROM THE TOP ROPE

"[There's this perception that] now that there's no interest in RadOnc, this is now an opportunity for Black physicians, Hispanic physicians, women physicians..."
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And as way know women and urm tend to be more geographically flexible, ...
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SIMUL THE GREAT WAS ON FIRE!!! Chelain and Trevor too WOOHOO!


Also, I think it is going to be hard to want best candidates + candidate who just wants to take care of patients + elimination of board scores, audition, interviews etc.

Even for myself, I thought "audition interviews" were a waste of time and money. Having to fly around the country to do so many interviews is cost prohibitive and very resource dependent. Research as well, not sure it was a waste of time, because ironically, it taught me that most research is worthless (this is not a trivial thing)!

If you have 2 candidates that are similar, but one did a gap year, did 5 rotations in rad onc all over the country, is published, great step I and loves his patients vs someone who didn't do many of those things due to limited resources, great step I and loves his patients how do we pick the 2nd?

I'm not trying to be funny, as I'm closer to the 2nd person in this example, and was SUPER STRESSED match week, knowing I couldn't afford applying and flying to many interviews.

It's good though these issues are being discussed openly and by the right people.
 
RadOncMegatron said:
SIMUL THE GREAT WAS ON FIRE!!! Chelain and Trevor too WOOHOO!


Also, I think it is going to be hard to want best candidates + candidate who just wants to take care of patients + elimination of board scores, audition, interviews etc.

Even for myself, I thought "audition interviews" were a waste of time and money. Having to fly around the country to do so many interviews is cost prohibitive and very resource dependent. Research as well, not sure it was a waste of time, because ironically, it taught me that most research is worthless (this is not a trivial thing)!

If you have 2 candidates that are similar, but one did a gap year, did 5 rotations in rad onc all over the country, is published, great step I and loves his patients vs someone who didn't do many of those things due to limited resources, great step I and loves his patients how do we pick the 2nd?

I'm not trying to be funny, as I'm closer to the 2nd person in this example, and was SUPER STRESSED match week, knowing I couldn't afford applying and flying to many interviews.

It's good though these issues are being discussed openly and by the right people.
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Agreed, this is exactly why SDN has rightfully so been the leaders in pushing back the nonsensical UCLA 1-year off to do research year at poverty level they are touting
 
RickyScott said:
Close second were 1) “let’s not worry about fractions and get back to treating patients” 2) trash about exposing more medstudents to radonc to drum up interest (and the amazing work Dan Golden has done) because fear of physics is the real issue.
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It's hard to hear boomers make point 1 and not be sickened by it. A generation who created the rules and exploited insurance companies now gets to tell young radiation oncologists who are suffering the consequences that they should "get back to treating patients." I hypofrac 90% of my patients, pretty sure my batting average is better than ol' lou's.

As for number 2, it's just a garbage argument but if he truly believes that med students are turned off from radonc because of physics then I'm sure getting rid of our radbio/physics boards would go a long way towards assuaging that fear. Or I guess we can just do the opposite and fail half the people taking the test.
 
I listen to the whole thing yesterday. This is my take away.

The anonymous posters on SDN were way out ahead of the curve by years on what is THE issue in rad onc. But despite this, there seems to be people in "leadership" positions that will only seem to believe something if its published in an academic journal.

Simul Parikh. Excellent three minute intro summary of his position, which is the positions that most younger grads and residents have. He spoke clearly and decisively in a well thought out position. I did like the way he framed the issue as "big rad onc" vs "little rad onc" ie academic establishment vs the 80% of everyone else.

Trevor Royce. Also excellent. Basically along the lines of Simul's position. Again spoke clearly and had data to back up his arguments.

Chelian Goodman. She also really did a great job. I went into the livestream prepared to not like her (based on prior publications) but she realistically acknowledges the issue of the specialty.

Chelsea Pinnix. Also acknowledges the issues. In fact see stated that MD Anderson will permanently be going from 7 residents/year to 6 residents/year. This has not been reflected in the data from the ACGME yet. But I will take her at her word. Too bad the specialty is loosing quality MD Anderson spots while growing UWV, UTenn and Darthmouth spots.

Brain Kavanaugh. I was surprised the he also seems to get whats going. He also stated his program will permanently be contracting by one resident (apparently this basically had to be cleared with his dean first). Again, this has not been reflected in the data from the ACGME yet.

Rahul Tendulkar. Also seemed to understand whats going.

Louis Potters. Wow. Came off just like he does on his editorials. Basically doesn't understand the issues and doesn't really seem to care unless it directly effects. All the same stuff about increasing diversity, medical student exposure, lets find new indications ect... The stats he sited were off like 70% of cancer patient get RT? Just a bunch of tangential thinking. Crazy/frighting he was president SCAROP. I wouldn't be surprised if his uninformed thought processes/ideas is shared by over >50% of that groups membership and that probably speaks volumes about the profession is currently in the position that it is. He did say that maybe we need to do a better job raising standards at training programs, which is something everyone agreed with (of course the RCC did nothing on this front two years ago with the "changes" that were made).


One big thing that was left out of the discussion is the fundamental question of how many rad oncs does this country realistically need? Is it 4000, 5000, 6000? This is a roughly knowable quantity and will inform how many we should be training. This is something that Astro, if it was representing everyone's interest, should know and always have data on. Instead they have completely been agnostic/derelict on this. This is why so many in the little rad onc community feel ignored by Astro.
 
Red J article by Flynn et al. If it was bad in 1995, it is much worse now...

The employment status of 1995 graduates from radiation oncology training programs in the United States...​


 
Radonc90 said:
Red J article by Flynn et al. If it was bad in 1995, it is much worse now...

The employment status of 1995 graduates from radiation oncology training programs in the United States...​


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Trevor mentioned this time period during the panel including the fact that spots were trimmed and training extended by a year. No such appetite for change now, just exploit excess grads with unaccredited "fellowships"
 
Article from Mudit Chowdhary, Trevor Royce et al (Practical Radiation Oncology, Nov. 2019):


Graph from the same article illustrating the # spots and # radonc residency programs period between 2003-2018:

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As others have said, I was impressed with the thoughtfulness of most of the discussants. Data was provided and referenced when appropriate. I would gladly vote for Pinnix, Royce, Goodman, Parikh, or Tendulkar for leadership positions now or in the future.

However, I'd like to draw attention to an important distinction between quality and quantity. These terms have been interchangeable throughout most of this discussion including the video. I would argue that all programs, job crisis or not, should be high quality. However, correcting quality will not lead to appropriate reductions in quantity. All programs regardless of quality need to reduce residency spots.
 
Agree,

The basic law of economy of supply and demand:

- Let's say a product is short (let's say we are short of radonc's), then we need many programs to produce more residents to care for patients.
- Now, there is an oversupply, then reduce quantity but increase quality (by closing low-quality programs).

The most difficult part is how to define quality. Once you define quality, then many newer programs (opened during the last 20 years as shown in the graph above) should either contract or close.

A confounding factor is FMGs (I have trained many FMGs over the years and they are very good), which now fill in
with SOAP. In a hypothetical situation with no FMGs, then the US med students "have spoken"...
 
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