What about radonc-radiology combined residency?

[IRattending2021]

Long time lurker on the board. Was thinking about radonc during med school but didn’t have the grades for it at the time so went into IR instead.

I am not so familiar with radonc training system but a lot of radiology’s PGY5 year is elective and some institution actually does an enfolded nuclear medicine fellowship, so you can possibly shave off a year in radiology training. What if radonc and rad can combine in a 6 or 7 year combined program (depends on how much time you can shave off in radonc).

I can see some students would be interested in becoming an oncological imaging and treatment expert that can also do an IR independent residency after and do everything imaging related.

It’s a bit of a throwback to the old days of therapeutic radiology but would also decrease the RO residency spot quite a bit possibly if some radonc spots convert to RO spot just like when Integrated IR happened it decreased diagnostic radiology spot somewhat.

Thoughts?

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[FrostyHammer]

Was thinking about radonc during med school but didn’t have the grades for it at the time so went into IR instead.

I got a chuckle at reading the statement above...my my my how the tables have turned...

 

[RadOncDoc21]

I got a chuckle at reading the statement above...my my my how the tables have turned...

Heard a rumor that PD’s are “desperately” trying to find suitable applicants now. It’s just a rumor but I’ve never heard of these kinds rumors in the past. What’s “suitable?” I have no idea!

 

[medgator]

Heard a rumor that PD’s are “desperately” trying to find suitable applicants now. It’s just a rumor but I’ve never heard of these kinds rumors in the past. What’s “suitable?” I have no idea!

Clean criminal background check, English literacy.

 

[fiji128]

Programs are likely to never voluntarily contract or shut down in a substantial way. They are much more likely to lower the bar, looking for those who can’t match in other specialities and FMG’s (assuming they can land prelim spots). Several academic department chairs have publicly said we need to welcome lower quality applicants (I guess so they don’t have to contract spots?).

I really think the only way forward is to fold rad onc back into radiology as a fellowship. This will prevent programs from matching applicants with no other options and those in the field will always be able to fall back on their general radiology training if need be.

 

[ramsesthenice]

Heard a rumor that PD’s are “desperately” trying to find suitable applicants now. It’s just a rumor but I’ve never heard of these kinds rumors in the past. What’s “suitable?” I have no idea!

It will be interesting to see who decides bottom tier residents are better than no residents. We interviewed a number of very good resident applicants this year but...

Even though we could have invited all, a solid quarter were bad enough on paper we didn’t even invite

won’t rank a quarter of those interviewed (traditionally rank more like 90%)

the good applicants can probably go anywhere and there are not that many of them

Are we officially the anti-GameStop? I still can’t believe how fast things have changed.

 

[elementaryschooleconomics]

It will be interesting to see who decides bottom tier residents are better than no residents. We interviewed a number of very good resident applicants this year but...

Even though we could have invited all, a solid quarter were bad enough on paper we didn’t even invite

won’t rank a quarter of those interviewed (traditionally rank more like 90%)

the good applicants can probably go anywhere and there are not that many of them

Are we officially the anti-GameStop? I still can’t believe how fast things have changed.

I'm curious to see how many dual-applicants there are...a lot of places interviewed more people than normal to compensate for the drop in students, but that will be all for naught if half of them hedged and also applied to IM.

 

[IRattending2021]

I got a chuckle at reading the statement above...my my my how the tables have turned...

In a way, I am pretty happy about it. I went to a upper mid tier program, a top tier fellowship and ended up in one of the most geographically competitive region in the country working in my dream academic job. Thankfully my field learned the lesson quickly from overexpansion back in 2015 when the applicant quality dropped a lot.

Somehow I don’t think I would be working in Manhattan if I’ve did radonc. How many graduating resident end up in NYC each year I wonder?

 

[FrostyHammer]

In a way, I am pretty happy about it. I went to a upper mid tier program, a top tier fellowship and ended up in one of the most geographically competitive region in the country working in my dream academic job. Thankfully my field learned the lesson quickly from overexpansion back in 2015 when the applicant quality dropped a lot.

Somehow I don’t think I would be working in Manhattan if I’ve did radonc. How many graduating resident end up in NYC each year I wonder?

Haha...if you mean Manhattan, Kansas then you're more like talking our language in radonc...

 

[IRattending2021]

Haha...if you mean Manhattan, Kansas then you're more like talking our language in radonc...

the little apple is a great place! Don’t diss it lol.

probably harder to find an IR job in the little apple than the big apple.

 

[medgator]

In a way, I am pretty happy about it. I went to a upper mid tier program, a top tier fellowship and ended up in one of the most geographically competitive region in the country working in my dream academic job. Thankfully my field learned the lesson quickly from overexpansion back in 2015 when the applicant quality dropped a lot.

Somehow I don’t think I would be working in Manhattan if I’ve did radonc. How many graduating resident end up in NYC each year I wonder?

There's jobs that do get posted in Manhattan. Not sure if they pay enough to cover renting someone's closet in midtown though

 

[medgator]

It will be interesting to see who decides bottom tier residents are better than no residents. We interviewed a number of very good resident applicants this year but...

Even though we could have invited all, a solid quarter were bad enough on paper we didn’t even invite

won’t rank a quarter of those interviewed (traditionally rank more like 90%)

the good applicants can probably go anywhere and there are not that many of them

Are we officially the anti-GameStop? I still can’t believe how fast things have changed.

What were your gross numbers of apps this year vs 5 years ago? I'm hearing many programs are seeing half to even less of what they were before

 

[ramsesthenice]

What were your gross numbers of apps this year vs 5 years ago? I'm hearing many programs are seeing half to even less of what they were before

About half. Seems to be across the board.

 

[ramsesthenice]

What were your gross numbers of apps this year vs 5 years ago? I'm hearing many programs are seeing half to even less of what they were before

As far as I could tell only 1 thing was up this year: FMG applicants. Some were pretty strong but as a whole, they have much higher rates of board failure (some taking step 1 3-4 times to pass). This one is tough because we all know the correlation between written board performance and clinical competence is meh at best and there are probably logistic/language barriers playing a part. Be it as it may, a lot of us can't really chance it. There are minimum first time pass standards we need to meet and when you have relatively small numbers of residents taking 3 exams all it takes is a few duds to sink your battleship. Boards failures are also viewed with great concern by prospective applicants. I hate to admit it but American or FMG, failure on any of the USMLE exams got a hard pass from me regardless of anything else in the application.

 

[RickyScott]

There are minimum first time pass standards we need to meet and when you have relatively small numbers of residents taking 3 exams all it takes is a few duds to sink your battleship. Boards failures are also viewed with great concern by prospective applicants. I hate to admit it but American or FMG, failure on any of the USMLE exams got a hard pass from me regardless of anything else in the application.

As well it should. Almost nobody fails step1 /2.

 

[ramsesthenice]

As well it should. Almost nobody fails step1 /2.

I'll be honest, I have never really thought much about FMGs or how they do on USMLE step exams. There is a lot of rogue memorization with low clinical yield. Are differences in preclinical medical education over represented on USMLE exams? How much does taking a board exam in a non-native language matter? I know I can recall getting flustered during hard stretches of the exams and having trouble remembering my own name in the moment. Even if you are proficient in another language that is still another layer you have to pull yourself back from in these moments. I am open to the idea that USMLE pass rates may not be apples to apples between US and FMGs. I just won't be taking chances with our program as a whole. Our pass rates are currently great and we could absorb some failures but if the quality of the pool keeps going down its possible that buffer might be smaller than it currently appears. We are 100% in the rather go unmatched than match a dud category.

Lest anyone think I am trashing FMGs, I am not. There were a lot of really outstanding FMGs. Especially from the middle eastern countries. Solid board scores. Excellent clinical training. Many have more clinical experience than US grads and are highly motivated individuals. We will be ranking a number of FMGs, some quite highly. All I was pointing out was that they were vastly over-represented in the otherwise good except for USMLE failure category.

 

[RickyScott]

There may not be a great correlation between usmle score and performance, but doubt that extends to passing the test. In terms of fmgs, I think it is wrong for programs to take fmgs in a speciality with an impacted job market, especially when medical education is subsidized. (Now there is scenario where us citizens, whose education and training were funded by us taxpayers will likely not find employment because you are importing fmg into government funded residencies?) would be ironic if you were at a state medical school that heavily favored in state applicants for similar reasons.

 

[ramsesthenice]

There may not be a great correlation between usmle score and performance, but doubt that extends to passing the test. In terms of fmgs, I think it is wrong for programs to take fmgs in a speciality with an impacted job market, especially when medical education is subsidized. (Now there is scenario where us citizens, whose education and training were funded by us taxpayers will likely not find employment because you are importing fmg into government funded residencies?) would be ironic if you were at a state medical school that heavily favored in state applicants for similar reasons.

I hear you but think what you are proposing is a very slippery slope. Turning away otherwise qualified applicants because you feel like others are more deserving of job placement because of factors x, y, and z. Without specific guidance from a governing body there is a word for that: discrimination.

I'd be all of ACGME or the ABR putting standards in place (since we know they won't just cut spots) but until they do our hands are kinda tied.