Any residents in hot spots being pulled out of the department?

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I would much rather do medicine floors than be an RT therapist right now

Are ppl really scared they’ve forgotten everything from prelim year?

hell I feel like I know more now than when I started PGY1 straight in ICU.

Can def do something useful to help tho I def don’t want to be managing vent settings
 
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Round and round we go. Stick to the facts people.

Rad Oncs and other outpatient providers will be pulled into the fray only when things go really sideways.

Rad oncs are extremely unlikely to be involved in intubation or running vents. More likely to cover inpatient oncology wards to free up the medicine teams to run ICUs. Or run screening etc.

Some of you are very certain what you will or won’t be willing to do and we know many of you are wrong. If it were to get to the point your system got overrun and people you know and work with were suffering some of you brave soldiers would suddenly wilt and others will would find the will to jump in. Outside of a vanishingly small minority none of us have had to face anything like this or know for sure how we would respond.
 
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Let's take right/wrong and "We took an oath" out of it for a moment. If your entire medical community is gutted and desperate for MDs to save lives, and you balk (assuming you are statistically low risk for COVID mortality), how do you all think that will play out for you in the long run? Even if you are true private practice and non employed, do you think all the docs and admins you stiff armed will just forget about it later?
 
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Save nyc hospitals, I would expect xrt residents and attendings could fill in for simple/routine non COVID issues to free up those who can work in icu setting.
 
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1. I have no problem with asking for rad onc volunteers.

2. Should be no hospital sanctioned punishment for saying no (esp if poor PPE).

3. Rad onc/path/ortho resident help should be called upon after even non academic family med or IM or other community docs have been offered the positions with appropriate compensation. Lots of private practice people out there not busy right now that probably have more training than others.
 
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Ah the so called “hippocratic oath”. Most know nothing but “primum non nocere”, first do no harm. It also contains a ban on doing something called “pesary” procedure, an abortion, not because Hippocrates was Mike Pence but because back then any “surgical procedures” were considered straight quackery. There was medicine and then there was the dark art of surgery. You know like a modern urology hack job. Did you take that oath as well? Relic of the past, most people don’t even know what is in it but what they see in it or wanna see in it, kinda like modern religion.

i think residents are upset because of the NYC admins literally being in a Florida mansion. Because nyc docs are being asked to volunteer and Harvard with billions in endowment, is cutting doc pay, stopping retirement contributions, while being bailed out. Bernie where are you? We need you! Because, there are no masks and just trash can bags. Because, once again residents are dumped on while “leadership” hides behind the trenches, etc etc.

If you are at a bad no good program, you’re used to being pissed on and having to thank the master for the rain. If you’re in Harvard rad onc you’re SHOOK.


we are not going to be asked to run a vent. Even as amazing as I was as an intern, they never let me by the vent with a 10 foot pole. You will be functioning as an intern under the orders of a fellow or an attending. If we get sick, no benefits and use up what little vacation is left. Sad times ahead.
 
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If it wasn't clear already, residents are absolute slaves. Nurses/NPs are getting paid 5k, 8k, 10k, even 13k a week as hazard pay and these residents are being repurposed in a warzone without adequate PPE for $1500 a week. It's all about the bottom line.
 
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RSAOaky said:
If it wasn't clear already, residents are absolute slaves. Nurses/NPs are getting paid 5k, 8k, 10k, even 13k a week as hazard pay and these residents are being repurposed in a warzone without adequate PPE for $1500 a week. It's all about the bottom line.
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have seen automatically generated ads on social media for 13-14k a week locums for nurses/NP/PA with all sort of perks during this time. i cannot locum but my email routinely has pleas for locuming, do all brachy, see consults and follow ups, take it or leave it rate of 1.2k per day (12 hr days). Really fun times to be in medicine. They can do this because a poor chap is actually taking this rate.
 
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thecarbonionangle said:
have seen automatically generated ads on social media for 13-14k a week locums for nurses/NP/PA with all sort of perks during this time. i cannot locum but my email routinely has pleas for locuming, do all brachy, see consults and follow ups, take it or leave it rate of 1.2k per day (12 hr days). Really fun times to be in medicine. They can do this because a poor chap is actually taking this rate.
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What are you trying to say, RadOnc MD locum market is going up or down?


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In the meantime:

apple.news

Nurses Die, Doctors Fall Sick and Panic Rises on Virus Front Lines — The New York Times

The pandemic has begun to sweep through New York City’s medical ranks, and anxiety is growing among normally dispassionate medical professionals.
apple.news apple.news

“A supervisor urged surgeons at Columbia University Irving Medical Center in Manhattan to volunteer for the front lines because half the intensive-care staff had already been sickened by coronavirus.”

“I feel like we’re all just being sent to slaughter,” said Thomas Riley, a nurse at Jacobi Medical Center in the Bronx, who has contracted the virus, along with his husband.”
 
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radoncdoc16 said:
I would much rather do medicine floors than be an RT therapist right now
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Amen to that. If we (MDs) really valued our fellow therapist (wo)man, we'd send them home and we would staff the linacs, set up, beam on, QA etc. We'd be on the front lines of patient contact in the cancer centers like the IM, anesthesia etc docs are in the hospitals right now. But rad oncs would come closer to turning on a vent and getting it working than they would actually running the linac. Thank God for the therapists no joke. It's having them around that we can even have discussions about pulling rad oncs out of the radiotherapy depts.
 
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You can’t run your own machines? That’s a failing of your residency, IMO.
 
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I know the docs on tv shows learned how to do all of that.
 
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chemsmith said:
I can't tell if you are being sarcastic. You learned to operate a linac in residency?
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I have actually tried to learn. I wouldn't trust me for routine operation but I could in a pinch. Radiation oncologists don't treat patients with radiation machines in ways analogous to anesthesiologists treating patients with anesthesia machines or surgeons treating patients with surgery machines. And who knows maybe it is a bit of a failing. I'm a total weirdo and would actually encourage this (learning how to run a machine, set patients up, do QA etc) if I were a PD. Guess it would be handy now and people woulda called me prescient.
 
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scarbrtj said:
I have actually tried to learn. I wouldn't trust me for routine operation but I could in a pinch. Radiation oncologists don't treat patients with radiation machines in ways analogous to anesthesiologists treating patients with anesthesia machines or surgeons treating patients with surgery machines. And who knows maybe it is a bit of a failing. I'm a total weirdo and would actually encourage this (learning how to run a machine, set patients up, do QA etc) if I were a PD. Guess it would be handy now and people woulda called me prescient.
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Or have them shadow techs for a few days, do the setups, take the kVs, etc. I think there’s value in that, similar to how the rest of our medical education is structured. At the very least I’ve always counseled my juniors to talk with dosimetry, talk to the techs, talk with physics, because otherwise things are as black box. And I still learn stuff from them each week.
 
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taserlaser said:
Or have them shadow techs for a few days, do the setups, take the kVs, etc. I think there’s value in that, similar to how the rest of our medical education is structured. At the very least I’ve always counseled my juniors to talk with dosimetry, talk to the techs, talk with physics, because otherwise things are as black box. And I still learn stuff from them each week.
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Notes aren't going to dictate themselves.
 
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RickyScott said:
you probably should spend one or 2 weeks in residency as tech and a month in dosimetry.
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i agree, a department that allows for some sort of therapy/dosimetry/physics rotation to learn about therapy, dosimetry and QA would be great. Sadly at many departments you’re just a warm body writing notes, making calls, getting records. They need you in clinic!!! How else will they survive?
 
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Mandelin Rain said:
Why couldn't you just record your virtual visit and enter the filmed visit into the EMR as documentation?
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If COVID-19 gets me to do less dictations and work remotely from home, I think I might have a new outlook on everything. Hopefully, I’ll make it to the other side to reap the rewards!
 
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thecarbonionangle said:
i agree, a department that allows for some sort of therapy/dosimetry/physics rotation to learn about therapy, dosimetry and QA would be great.
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Agreed. While at my institution we don't spend time with the therapists, I am at the machine enough to evaluate breast set-ups and look at set-up films that I could be a useful second set of hands to a therapist who knew what he/she was doing.

We don't have a formalized QA curriculum but that's actually a really good idea to put 'QA' into a more concrete thing than a black box topic.

We do have a formalized dosimetry curriculum where we act as dosimetrists and learn to plan cases of all complexity, starting with basic 3D plans and ranging up to SRS/SBRT and complex IMRT (H&N, Gyn Pelvis), so at least we got that going for us.
 
What happens if residents don’t get enough cases this year as a result of delaying or not treating patients? Repeat the year? I know program directors are busy SOAPing right now but is someone going to hold them accountable for making sure that promotion to the next year is audited correctly?
 
xrt123 said:
What happens if residents don’t get enough cases this year as a result of delaying or not treating patients? Repeat the year? I know program directors are busy SOAPing right now but is someone going to hold them accountable for making sure that promotion to the next year is audited correctly?
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ACGME sent something about case loads and understanding the impact of COVID on these requirements
 
xrt123 said:
What happens if residents don’t get enough cases this year as a result of delaying or not treating patients? Repeat the year? I know program directors are busy SOAPing right now but is someone going to hold them accountable for making sure that promotion to the next year is audited correctly?
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I don’t think there is a minimum Annual case requirement

There is a maximum annual as well as minimum cumulative case load

also a minimum amount of time in radonc clinicals. So programs whose residents have already served 12 months of research and then get reassigned could potentially be in trouble if ACGME decided to care
 
radoncdoc16 said:
I don’t think there is a minimum Annual case requirement

There is a maximum annual as well as minimum cumulative case load

also a minimum amount of time in radonc clinicals. So programs whose residents have already served 12 months of research and then get reassigned could potentially be in trouble if ACGME decided to care
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ACGME has already made a decision that allowances will be made for less than normal case volume in this situation. At least that's the case for case minimums in family medicine. Unclear whether similar allowances will be made for radiation oncology.
 
radoncdoc16 said:
I don’t think there is a minimum Annual case requirement

There is a maximum annual as well as minimum cumulative case load

also a minimum amount of time in radonc clinicals. So programs whose residents have already served 12 months of research and then get reassigned could potentially be in trouble if ACGME decided to care
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Minimum total was 450 i thought....
 
Heard two residents died in NYC in past 24 hours and one in Detroit.

Any validity?
 
thecarbonionangle said:
this is coming to your hospital. Sad times ahead. They are gonna throw us all into death pits
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Very sad times. Looks like there's a gag order about what the tweet mentioned. They throw you in the pit and pretend you never existed. Sad
 
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Zahramar said:
Very sad times. Looks like there's a gag order about what the tweet mentioned. They throw you in the pit and pretend you never existed. Sad
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Still showing up when i click on it.
 

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