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Congratulations, only 109 Rad onc MD applicants this year; with total 176 applicants. Soon Rad onc will be an escape for those who didn't match in the SOAP, and a guaranteed visa for FMGs that want to move to the United States.

Grad TypeERAS 2016ERAS 2017ERAS 2018ERAS 2019ERAS 2020ERAS 2021
DO103981016
IMG443819304051
MD215233213183143109
 
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RickyScott

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If sdn did not exist, medstudents -who tend to be dumb-would be happily piling into the specialty. Not.
 
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Congratulations, only 109 Rad onc MD applicants this year; with total 176 applicants

Grad TypeERAS 2016ERAS 2017ERAS 2018ERAS 2019ERAS 2020ERAS 2021
DO103981016
IMG443819304051
MD215233213183143109

It's the right direction. I think what we actually want is for the wonderful specialty of Radiation Oncology to have strong leadership from ASTRO, the ABR, and academic chairs/departments - leadership which would guide and protect it in such a way that patients and doctors both benefit.

Right now, it's just a bunch of random people on a message board using data to make arguments to steer medical students away from making terrible personal decisions.
 
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Congratulations, only 109 Rad onc MD applicants this year; with total 176 applicants. Soon Rad onc will be an escape for those who didn't match in the SOAP, and a guaranteed visa for FMGs that want to move to the United States.

Grad TypeERAS 2016ERAS 2017ERAS 2018ERAS 2019ERAS 2020ERAS 2021
DO103981016
IMG443819304051
MD215233213183143109
Link to Source?
 

Ray D. Ayshun

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As @elementaryschooleconomics said, the collapse of the field is not what we want. This is finally, perhaps, rock solid, indisputable evidence that we should get what we want, which is a more reasonable training cohort. Given how things have and will change wrt radiation utilization and duration, supply is already outstripping demand, and will only get worse. This sucks if you're the supply. It's elementary school economics...
 
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Chartreuse Wombat

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Medical students Canaries have spoken....Probably 160-180 spots in match...The field is returning to its roots
 
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Radonc90

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The "leaders" would fill with IMG and SOAP anyway.
The problem will be there for the next 20 yrs, unless the "leaders" retire ASAP...


---
Just saw this tweet today from a non-radonc:
 
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StIGMA

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Programs know that the current residents are the cream of the crop. Several programs have made specific efforts to aggressively hire during this peak. Programs know quality will be declining after the peak (2019 incoming class seems like fair cut point) and want to hire now if there are clear needs. I expect grads in 5+ years from now to have this additional factor weighed against them unless training/CV record is outstanding.
 
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RadOncG

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Applications per program shows the collapse of competitiveness over time. Programs are now getting 36% of the US MD applications that they got in 2017.

Not only are there fewer applicants but the applicants are applying to far fewer programs. I suspect many people this year are dual applying just like last year.

Grad TypeERAS 2016ERAS 2017ERAS 2018ERAS 2019ERAS 2020ERAS 2021
DO7.062.436.743.374.598.96
IMG14.3610.987.4511.3815.9418.96
MD147.71159.38147.74120.8381.8156.65
Total169.13172.79161.93135.58102.3484.57
 
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RickyScott

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---
The leaders are putting on “masterclasses” in leadership.
 
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thecarbonionangle

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LOVE IT. it will only get worst. You ain’t seen nothing yet baby. The breadlines are a’coming!
 
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thecarbonionangle

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The rats are jumping ship! Lol.
Even the rats are no longer seduced or distracted by the cheddar, the serenating fiddler or violinist as the ship sinks. The rats are gone onto bigger cheesier and better things. I sleep in the swamp just a bit happier today.
 
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Programs know that the current residents are the cream of the crop. Several programs have made specific efforts to aggressively hire during this peak. Programs know quality will be declining after the peak (2019 incoming class seems like fair cut point) and want to hire now if there are clear needs. I expect grads in 5+ years from now to have this additional factor weighed against them unless training/CV record is outstanding.

I heard a faculty member make this statement ~3 weeks ago. It seems logical and I don't know where he heard it, I've never heard this person comment on the market before (doesn't mean he doesn't, just that I've never heard it).

It's hilarious because academic departments are extra strapped/restricted this year due to COVID, with university-wide limits on hiring which prevent them from "hiring for the future".
 
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DebtRising

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I want people to know all the things I didn’t when I applied, and I want a field where leadership actually cares about those entering.

That over 100 US grads still applied is a terrible sign for 10 years from now if older docs are not retiring, there is a whole crop in front of them already training, and all the supply / demand trends and factors discussed remain even 30% accurate.
 
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Neuronix

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Last year the application numbers were down too, and pretty much every spot filled in SOAP. Will this year be another repeat?

There are still plenty of desperate people out there willing to take a chance. The job market will continue to worsen as long as those spots are filled in one way or another. It won't matter if you trained at Kansas or Harvard--salaries will race to the bottom and fellowships will expand as we all become easier and easier to replace.

Also, the thread title makes me sick to my stomach. This situation is not what I want. I want a growing specialty with a good choice of jobs for radiation oncologists. The current situation is a nightmare for the young generation of attendings and senior residents.The drop in residency applications is a result of the reality that we are overtraining. We got what we wanted? That is completely false. We want the situation to correct. I personally think the jobs situation will continue to worsen given that the spots will fill through soap anyway. So even if you think it's great that less American MDs are applying to the specialty, we still have and will worsen the oversupply not even accounting for serious threats on the horizon like APM. "Got what we wanted", not at all. Don't twist things. The med students are reacting to a reality that none of us want.
 
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StIGMA

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I heard a faculty member make this statement ~3 weeks ago. It seems logical and I don't know where he heard it, I've never heard this person comment on the market before (doesn't mean he doesn't, just that I've never heard it).

It's hilarious because academic departments are extra strapped/restricted this year due to COVID, with university-wide limits on hiring which prevent them from "hiring for the future".

I can say I heard this from someone at the ASTRO President or equivalent level.
 
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Haybrant

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Programs know that the current residents are the cream of the crop. Several programs have made specific efforts to aggressively hire during this peak. Programs know quality will be declining after the peak (2019 incoming class seems like fair cut point) and want to hire now if there are clear needs. I expect grads in 5+ years to have this additional factor weighed against them unless training/CV record is outstanding.

This is a very good point. No clue why IMGs would think they can get into some backdoor. They just won’t be hired or will compete with each other for some pretty cruddy rural jobs. Hope you fmgs are reading too, don’t apply into rad onc huge waste of your time.
 
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DebtRising

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Neuronix’s rebuttal is spot on - the only people who got what they wanted are senior academics and senior private practice docs who can farm out and exploit young grads and keep more of the ever shrinking pie for themselves. Which is so much more disgusting with the outright disinformation on the job situation, the fellowship expansion, the lack of private practice partnerships. They have won, we have lost and our careers and the impact our careers have on our lives suffer for it.

If programs want to keep abusing people by offering spots to IMGs or to candidates who barely scrape by the boards - I can’t stop that. There should be a moral imperative to have adequate oversight of supply and demand so that people aren’t forced to do non accredited fellowships, or work twice as hard for less salary than someone who graduated 20 years ago while accepting less geographic or ascendant mobility. I am still “lucky” to have a job with a good salary - but I put in over a decade and hundreds of thousands into it, did well in medical school and residency and had choices of what to do -I feel my choice was abused by the leadership and I do not feel this career will last more than 15 or 20 years.

I do think it’s great less MDs are applying because at least it means the information is getting across to some. I also work in my non anonymous role to help this cause. But I cannot provide the morals to these places, or even the common sense, that with less demand less supply is needed. I cannot convince chairs who make more than I ever will that making and offering non accredited fellowships to basically exploit cheap labor is manipulative and predatory. Take what I can get
 
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medgator

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Neuronix’s rebuttal is spot on - the only people who got what they wanted are senior academics and senior private practice docs who can farm out and exploit young grads and keep more of the ever shrinking pie for themselves. Which is so much more disgusting with the outright disinformation on the job situation, the fellowship expansion, the lack of private practice partnerships. They have won, we have lost and our careers and the impact our careers have on our lives suffer for it.
Let's lay the blame at the source of the problem... Greedy academic chairs and weak/complicit PDs/faculty that have allowed rampant expansion to happen
 
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Chartreuse Wombat

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Neuronix’s rebuttal is spot on - the only people who got what they wanted are senior academics and senior private practice docs who can farm out and exploit young grads and keep more of the ever shrinking pie for themselves. Which is so much more disgusting with the outright disinformation on the job situation, the fellowship expansion, the lack of private practice partnerships. They have won, we have lost and our careers and the impact our careers have on our lives suffer for it.

If programs want to keep abusing people by offering spots to IMGs or to candidates who barely scrape by the boards - I can’t stop that. There should be a moral imperative to have adequate oversight of supply and demand so that people aren’t forced to do non accredited fellowships, or work twice as hard for less salary than someone who graduated 20 years ago while accepting less geographic or ascendant mobility. I am still “lucky” to have a job with a good salary - but I put in over a decade and hundreds of thousands into it, did well in medical school and residency and had choices of what to do -I feel my choice was abused by the leadership and I do not feel this career will last more than 15 or 20 years.

I do think it’s great less MDs are applying because at least it means the information is getting across to some. I also work in my non anonymous role to help this cause. But I cannot provide the morals to these places, or even the common sense, that with less demand less supply is needed. I cannot convince chairs who make more than I ever will that making and offering non accredited fellowships to basically exploit cheap labor is manipulative and predatory. Take what I can get
Don't forget the health systems/hospitals. They are happy to have an oversupply so they can pay pennies on the dollar. Academic chairs will soon be just cogs in a giant machine. Their salaries will fall as well as the health system continues to consolidate. As i have said many times before their are winners and losers in an oversupply scenario-if you are an employer you are a winner...may who know view themselves as employers will be employees soon enough...
 
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Perhaps this is too optimistic, but for selfish reasons, I'm curious what people think. For those of us in the pre-2019 entering classes, could this attitude end up actually helping the job market?

What I mean is, is the "supply" of rad oncs going to be artificially lowered in the eyes of employers who may be hesitant to hire someone in a 2020 or later class. So everyone after 2020 has (unfortunately) a significantly higher chance of just being outright unemployed, while the 2019 and prior people get more of their pick for jobs? I don't know if I'm explaining myself well, but could employers view the 2020+ classes almost as if they're not even in the job market? Obviously employers want to hire for cheap, but if they're genuinely concerned about outcomes will that overpower their need to find the lowest common denominator to fill a position?
 
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Obviously employers want to hire for cheap, but if they're genuinely concerned about outcomes will that overpower their need to find the lowest common denominator to fill a position?

You have a very charitable view of hospital administrators. On the whole, I doubt it. The net effect will still be to make working conditions worse.
 
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scarbrtj

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Don't forget the health systems/hospitals. They are happy to have an oversupply so they can pay pennies on the dollar. Academic chairs will soon be just cogs in a giant machine.
If one can answer yes to the question "Am I OK to work to make more money for everyone else than I do for myself with the added privilege of them telling me how and when to do my job in which they have no training?" then modern American medicine is for you!
 
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GapCalc

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My group is anticipating retirements over the next 2-4 years and have discussed hiring from the current crop of well-trained applicants, as we anticipate a quality drop. We’ll be a little oversubscribed for a year or two but it’s better than hiring someone who SOAPed into the speciality and being stuck with them for many years.
 
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RickyScott

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don’t buy the “hire now approach” because the residents will suck in 5 yrs. If in 5 years, you need to hire, just call up an md/phd aoa 260 type who has been exiled to North Dakota for the past 7 years. You will get experience + cv!
 
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deleted605854

If one can answer yes to the question "Am I OK to work to make more money for everyone else than I do for myself with the added privilege of them telling me how and when to do my job in which they have no training?" then modern American medicine is for you!

How does one become one of those people that commands the doctors ?

Asking out of curiosity......

1603643322059.png
 
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RickyScott

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Scowl a lot and talk definitively about everything. Take some self promotion from the trump playbook.
 
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bluebubbles

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Programs know that the current residents are the cream of the crop. Several programs have made specific efforts to aggressively hire during this peak. Programs know quality will be declining after the peak (2019 incoming class seems like fair cut point) and want to hire now if there are clear needs. I expect grads in 5+ years from now to have this additional factor weighed against them unless training/CV record is outstanding.

I can say I heard this from someone at the ASTRO President or equivalent level.

I made these [rather obvious] predictions over a year ago. I'm not the ASTRO President though.

My guess is that a combination of factors is driving a higher # of interviews:
- [...]
- Increased hiring from academic practices due to concern that resident quality will go down a few years down the line; this is likely a minor factor but it's food for thought

As the word gets out, FMG's and bottom of the barrel medical students clamor into radiation oncology. Programs fill through SOAP but they fill. I will be getting as far away from academics as possible after graduating residency and I'd encourage anyone with any skill or interest in teaching to do the same.

I wish I was kidding but I'm not. This may be the best future we can hope for. Talk about dystopian.
 
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bluebubbles

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What I mean is, is the "supply" of rad oncs going to be artificially lowered in the eyes of employers who may be hesitant to hire someone in a 2020 or later class. So everyone after 2020 has (unfortunately) a significantly higher chance of just being outright unemployed, while the 2019 and prior people get more of their pick for jobs? I don't know if I'm explaining myself well, but could employers view the 2020+ classes almost as if they're not even in the job market? Obviously employers want to hire for cheap, but if they're genuinely concerned about outcomes will that overpower their need to find the lowest common denominator to fill a position?

Having been through the job search process this year, I absolutely believe this will be a driving dynamic in the job market. Reputable hospitals, top academic practices, multispecialty groups, and physician-owned radiation oncology groups recognize that an exceptional radiation oncologist with a Trilogy is worth more than a crappy radiation oncologist with a brand-new Truebeam/Edge. Of course, some rural practices and disgusting for-profit chains (e.g. HCA) will prefer to hire the crappy radiation oncologist for pennies.

Also, I wouldn't say that entering class of 2017 vs. entering class of 2021 is a marker of quality, but you bet that employers look at your CV prior to your residency program. Maybe MSKCC's residency can make a crappy med student into a superstar, but an average residency program? Dream on.

Finally, I wouldn't wish any ill fate on any current or future trainee, MD, DO, Caribbean, IMG, but in my mind, I've done more than my duty. I've warned students against rad onc on the Internet and IRL, I've mentored students rotating through my department and spoken with them honestly about the job market, and lastly, I'm getting far, far away from academics so I'm not a party to the hypocrisy, exploitation, and falsehoods espoused by academic leaders.

Peace out.
-bluebubbles
 
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medgator

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don’t buy the “hire now approach” because the residents will suck in 5 yrs. If in 5 years, you need to hire, just call up an md/phd aoa 260 type who has been exiled to North Dakota for the past 7 years. You will get experience + cv!
Exactly.... Which is all the more reason why I'd be concerned as a US MD student trying to match in now. IMG DO caribbean etc know what they are getting into if they still try to grab mid to bottom tier spots at this point as @bluebubbles alluded to
 
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thecarbonionangle

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Perhaps this is too optimistic, but for selfish reasons, I'm curious what people think. For those of us in the pre-2019 entering classes, could this attitude end up actually helping the job market?

What I mean is, is the "supply" of rad oncs going to be artificially lowered in the eyes of employers who may be hesitant to hire someone in a 2020 or later class. So everyone after 2020 has (unfortunately) a significantly higher chance of just being outright unemployed, while the 2019 and prior people get more of their pick for jobs? I don't know if I'm explaining myself well, but could employers view the 2020+ classes almost as if they're not even in the job market? Obviously employers want to hire for cheap, but if they're genuinely concerned about outcomes will that overpower their need to find the lowest common denominator to fill a position?

lol you are one optimistic chap. I hope you are right!
 

Ray D. Ayshun

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This is most granular data of a graduating class that I have seen. 179/183 residents accounted for. At least 95% of residents got non-fellowship jobs. Only 4 fellowships identified. ~85% of graduates going to cities >250k. Would love to see how this compares to old classes.


View attachment 321340

View attachment 321341

Can't argue with not knowing what it used to be like, but this is metro areas, or some version thereof, and not cities. Iow, 85 % of grads went somewhere at least as big as ft. Smith, ar (according to wiki), which is the 192nd biggest. I went to a very small town (by choice fwiw), but wouldve been in that 85%. The real question is how many linacs aren't included in that 250k metric? Is there one in gore, oklahoma? If so, count it! Kind of a misleading/useless stat.
 
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Reaganite

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Perhaps this is too optimistic, but for selfish reasons, I'm curious what people think. For those of us in the pre-2019 entering classes, could this attitude end up actually helping the job market?

What I mean is, is the "supply" of rad oncs going to be artificially lowered in the eyes of employers who may be hesitant to hire someone in a 2020 or later class. So everyone after 2020 has (unfortunately) a significantly higher chance of just being outright unemployed, while the 2019 and prior people get more of their pick for jobs? I don't know if I'm explaining myself well, but could employers view the 2020+ classes almost as if they're not even in the job market? Obviously employers want to hire for cheap, but if they're genuinely concerned about outcomes will that overpower their need to find the lowest common denominator to fill a position?

Dude...no. The academic chairs and their MBA overloads don't give 2 ****s. They want warm bodies and cheap labor. I've been locked in battles with several academic places, so I'm familiar with their tactics. They're starting to hire DO's and FMGs in my neck of the woods for all sorts of oncology-related specialties. They slap on a name brand badge and tout them as "cancer experts" to the local insurers. Docs who were the laughing stock of tumor boards back in their PP days are now showing up on billboards as "experts." These guys will stop at nothing and the government is completely complicit. (Yeah, I sound like a conspiracy theorist lol). There are several academic satellites in my area that have practically been reduced to ashes by competition from local PP guys, but they don't close. Why? Because they just switch over their licenses to the hospital. These NCI designated cancer centers get paid such ridiculous rates they can keep xrt centers open with 5 patients and even turn a profit. They won't stop and they don't care about us.
 
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deleted605854

I've
Dude...no. The academic chairs and their MBA overloads don't give 2 ****s. They want warm bodies and cheap labor. I've been locked in battles with several reputable academic places, so I'm familiar with their tactics. They're starting to hire DO's and FMGs in my neck of the woods for all sorts of oncology-related specialties. They slap on a name brand badge and tout them as "cancer experts" to the local insurers. Docs who were the laughing stock of tumor boards back in their PP days are now showing up on billboards as "experts." These guys will stop at nothing and the government is completely complicit. (Yeah, I sound like a conspiracy theorist lol). There are several academic satellites in my area that have practically been reduced to ashes by competition from local PP guys, but they don't close. Why? Because they just switch over their licenses to the hospital. These NCI designated cancer centers get paid such ridiculous rates they can keep xrt centers open with 5 patients and even turn a profit. They won't stop and they don't care about us.
[/QUOTE

Yeah, I've always been puzzled at how their satellites can still function. They must be billing crazy amounts if that's the case.
 

MegaVoltagePhoton

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I disagree. If they can hire someone who looks better on paper they will. It’s about spin.

however, it’s still polishing a turd and the incoming classes are very screwed
 
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thecarbonionangle

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As long as the powers say someone is an “expert” they are exactly that, experts. Same with “leaders” in this field, as long as someone says they are leaders. Reality does not matter at all. This is a post truth specialty.
 
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MegaVoltagePhoton

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As long as the powers say someone is an “expert” they are exactly that, experts. Same with “leaders” in this field, as long as someone says they are leaders. Reality does not matter at all. This is a post truth specialty.

true but in this day and age patients use google etc, and while rad onc has gone down the toilet other specialties have not. Often other specialists are involved in hiring at least peripherally in multi specialty groups and academics. I for example interviewed with multiple med oncs and gyn oncs.

The persons point, I think, was that the hiring committees would rather hire someone with an elite pedigree than a DO/FMG. RadOnc who matched in 2019 and prior is filled with great pedigrees and high achievers. Rad onc 2020 and on has a number of questionable folks. It’s clear who will look better from an employers perspective.

Again it’s polishing a turd, because the high achievers will be scrambling for positions that don’t exist anyway. But I do agree that those matching in 2019 and below have a relative edge.
 
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medgator

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true but in this day and age patients use google etc, and while rad onc has gone down the toilet other specialties have not. Often other specialists are involved in hiring at least peripherally in multi specialty groups and academics. I for example interviewed with multiple med oncs and gyn oncs.

The persons point, I think, was that the hiring committees would rather hire someone with an elite pedigree than a DO/FMG. RadOnc who matched in 2019 and prior is filled with great pedigrees and high achievers. Rad onc 2020 and on has a number of questionable folks. It’s clear who will look better from an employers perspective.

Again it’s polishing a turd, because the high achievers will be scrambling for positions that don’t exist anyway. But I do agree that those matching in 2019 and below have a relative edge.
Agree, pts still look at undergrad/med school, not just residency when it comes to checking out a doc out in the real world
 
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deleted605854

Congratulations, only 109 Rad onc MD applicants this year; with total 176 applicants. Soon Rad onc will be an escape for those who didn't match in the SOAP, and a guaranteed visa for FMGs that want to move to the United States.

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MD215233213183143109

I've met a not so insignificant percentage of the US MDs that applied this year

They're from very diverse backgrounds, I'll say that much. Each one of them has applied to rad onc.

I am going to feel very sorry for them when they're more or less strong armed into a job that offers them a 0% chance of living comfortably post rad onc residency

For what it's worth I warned them and I was unsuccessful.
 
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Radonc90

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I agree with what Neuronix said above...

The title is a bit of drama, it is NOT what I want or any of us wants...

What we want...the list should be:

1. Happy radoncs treating cancer pts.

2. Competent radoncs.

3. Equilibrium of the 1990s: basically 100-110 new PGY-5 graduating per year and 100-110 radoncs retiring.

4. Too bad the prediction from 2010 was bad and everyone seemed to listen to it and expanded programs.

5. The hypofrax, actually they should have seen it coming even 20 years ago, data from the UK, Canadian studies already showed in many situations, hyprofrax is safe. What did the US do? We were paid by the # fractions and the subsequent abuse of IMRT caught the gov attention. Radoncs hands in the cookie jar!!!
How could the "leaders" in the radonc field not know this was not coming?
The leaders thought the gov has unlimited cash?

6. Then Covid came (this one was not in the forecast).

PS: We treat shorter and shorter fractionation, medonc treats the pt longer and longer, forever, some maintenance chemo + IO runs forever, even up to the week before the pt's death...
No wonder medonc people drain gov Medicare budget but somehow they get away...
 
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OTN

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As long as the powers say someone is an “expert” they are exactly that, experts. Same with “leaders” in this field, as long as someone says they are leaders. Reality does not matter at all. This is a post truth specialty.

This is very evident in the amplification of voices of residents on Twitter, with the academic Twitterati claiming they're "rising stars in the field" or "geniuses of radonc" or the ubiquitous FIRE FIRE FIRE emoji we see so much. When one looks into the actual research they've done, though, while admirable and more than I accomplished in training, it usually has zero clinical impact.

I'm all for supporting young trainees in the field, but overzealous promotion erodes the credibility of the poster/field.
 
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thecarbonionangle

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This is very evident in the amplification of voices of residents on Twitter, with the academic Twitterati claiming they're "rising stars in the field" or "geniuses of radonc" or the ubiquitous FIRE FIRE FIRE emoji we see so much. When one looks into the actual research they've done, though, while admirable and more than I accomplished in training, it usually has zero clinical impact.

I'm all for supporting young trainees in the field, but overzealous promotion erodes the credibility of the poster/field.

lots of inflated turds, young and old. Twitter attracts them.
 
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I agree with what Neuronix said above...

The title is a bit of drama, it is NOT what I want or any of us wants...

What we want...the list should be:

1. Happy radoncs treating cancer pts.

2. Competent radoncs.

3. Equilibrium of the 1990s: basically 100-110 new PGY-5 graduating per year and 100-110 radoncs retiring.

4. Too bad the prediction from 2010 was bad and everyone seemed to listened to it and expanded programs.

5. The hypofrax, actually they should have seen it coming even 20 years ago, data from the UK, Canadian studies already showed in many situations, hyprofrax is safe. What did the US do? We were paid by the # fractions and the subsequent abuse of IMRT caught the gov attention. Radoncs hands in the cookie jar!!!
How could the "leaders" in the radonc field not know this was not coming?
The leaders thought the gov has unlimited cash?

6. Then Covid came (this one was not in the forecast).

PS: We treat shorter and shorter fractionation, medonc treats the pt longer and longer, forever, some maintenance chemo + IO runs forever, even up to the week before the pt's death...
No wonder medonc people drain gov Medicare budget but somehow they get away...

This is SUCH a reasonable viewpoint.

Yet it's so far away from the reality we're living in right now.
 
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