Astro Career Center and "A Roadmap for Recruiting Medical Students into Radiation Oncology during a Period of Waning Interest"

[MidwestRadOnc]

Where do these admins come up with this stuff?

They come up with it in competitive areas because they know someone will take it. Rural colorado might get away with it because enough people think mountains are pretty. Rural Nebraska, probably not. I've seen contract with reverse-tiered RVU structures so you work for less and less then eventually for free if you're super busy. Admins lie and say their hands are tied because of FMV. What else are you going to do, build your own vault? Hahaha.

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Members don't see this ad.

 

[BobbyHeenan]

They come up with it in competitive areas because they know someone will take it. Rural colorado might get away with it because enough people think mountains are pretty. Rural Nebraska, probably not. I've seen contract with reverse-tiered RVU structures so you work for less and less then eventually for free if you're super busy. Admins lie and say their hands are tied because of FMV. What else are you going to do, build your own vault? Hahaha.

At the end of the day the market will determine the rates, that's correct. But it seems short-sighted to some degree by admins. It takes away any hustle incentive.

 

[Ray D. Ayshun]

I knew someone in a different part of the country with a contract like that right out of residency. WTF? He of course left after a couple of years when he learned about RVU's, etc and practice income/structure.

WHy would you make less per RVU in November than in January? What incentive is there to grow/get busier?

Where do these admins come up with this stuff?

the marginal tax rate is higher on November income than January.

 

[MidwestRadOnc]

At the end of the day the market will determine the rates, that's correct. But it seems short-sighted to some degree by admins. It takes away any hustle incentive.

It is truly baffling the lengths hospitals will go through to keep doctors on a base+RVU bonus scheme at their base level. It is mutually beneficial to produce more, but somewhere in admin school it is taught that letting a doctor go above median RVU is a bad thing and better to just hire another one at that point. Often I wonder if just eat-what-you-kill RVU is better as there is no question about "making up your base" and "bonus" beyond that.

the marginal tax rate is higher on November income than January.

I'd rather pay 37% on something than 35% on nothing.

 

[radiaterMike]

the marginal tax rate is higher on November income than January.

But you are not paying OASDI (>6%) in November

 

[Ray D. Ayshun]

Yeah, y'all got me. It is better to get paid more money.

 

[thecarbonionangle]

I was just looking at the astro job board and it remains a total mess. Such a low hanging fruit for “leadership” and still mixes in other specialty jobs (the famous janitor job posting comes to mind). I still do not even see a way to say can you just show me rad onc jobs only?

 

[medgator]

I was just looking at the astro job board and it remains a total mess. Such a low hanging fruit for “leadership” and still mixes in other specialty jobs (the famous janitor job posting comes to mind). I still do not even see a way to say can you just show me rad onc jobs only?

Everyone knows the best rad onc jobs never post to ASTRO anyways (or if they do, it's a practice/institution requirement to go through the motions etc).

 

[thecarbonionangle]

Everyone knows the best rad onc jobs never post to ASTRO anyways (or if they do, it's a practice/institution requirement to go through the motions etc).

Is this seen in other fields or this one of those unique toxic rad onc things? the secret jobs out there that only if you secret hand shake enough, you might be invited to, like in squid game.

 

[medgator]

Is this seen in other fields or this one of those unique toxic rad onc things? the secret jobs out there that only if you secret hand shake enough, you might be invited to, like in squid game.

No. Med onc and GUs coming out of training get wined and dined in almost any metro they want to.

The job quality crisis to chairs and high ranking faculty is a feature not a bug.

 

[RickyScott]

Is this seen in other fields or this one of those unique toxic rad onc things? the secret jobs out there that only if you secret hand shake enough, you might be invited to, like in squid game.

Most radoncs are employed by large systems and these systems are almost always required to post jobs even if they have a candidate in mind. Somehow this myth of secret stash of high paying jobs persists to gas light medical students and residents.

 

[MidwestRadOnc]

Most radoncs are employed by large systems and these systems are almost always required to post jobs even if they have a candidate in mind. Somehow this myth of secret stash of high paying jobs persists to gas light medical students and residents.

They also have to post them if hiring visa candidate. Maybe explains the jobs permanently posted in middle of nowhere.

 

[RadRadRad]

Years ago I heard that some hospitals had the opposite of reverse tier rvu. Paid incrementally more as you went up in percentile of rvu. Rationale I think was that you save money in benefits by not hiring another doc.

 

[Mandelin Rain]

I was just looking at the astro job board and it remains a total mess. Such a low hanging fruit for “leadership” and still mixes in other specialty jobs (the famous janitor job posting comes to mind). I still do not even see a way to say can you just show me rad onc jobs only?

 

[TheWallnerus]

I was just looking at the astro job board and it remains a total mess. Such a low hanging fruit for “leadership” and still mixes in other specialty jobs (the famous janitor job posting comes to mind). I still do not even see a way to say can you just show me rad onc jobs only?

Man rad onc has so many jobs ASTRO would need 50 FTEs to keep the job board organized. Why the hate?????

 

[NotMattSpraker]

Man rad onc has so many jobs ASTRO would need 50 FTEs to keep the job board organized. Why the hate?????

ASTRO thinks the job board is soooo valuable and basically everyone else doesn't care haha.

It is weird even among weird ASTRO things. I wonder how much money they make on it.

We are hiring and are using job ads for real to see who applies, not just as a formality. But I dont think any of us think about or care where they heard about us. Most found us in the secret stash I guess, wish I knew about that in residency

 

[RickyScott]

ASTRO thinks the job board is soooo valuable and basically everyone else doesn't care haha.

It is weird even among weird ASTRO things. I wonder how much money they make on it.

We are hiring and are using job ads for real to see who applies, not just as a formality. But I dont think any of us think about or care where they heard about us. Most found us in the secret stash I guess, wish I knew about that in residency

20 years ago there were secret jobs with Princeton and coia group etc. those groups don’t exist anymore or in the case of sero, don’t have partnership tracts. Another legacy of atsros malfeascence and residency expansion.

 

[OTN]

20 years ago there were secret jobs with Princeton and coia group etc. those groups don’t exist anymore or in the case of sero, don’t have partnership tracts. Another legacy of atsros malfeascence and residency expansion.

SERO doesn't have a partnership track anymore?

 

[drowsy12]

They do. They have one newer position at a newly acquired site that has been posted in the recent years that was specifically employment only though.

 

[NotMattSpraker]

SERO doesn't have a partnership track anymore?

SERO guy had some interesting stuff to say at the ARRO day panel I was on. He said they liked to look for residents that do a lot of research because it speaks to them being able to juggle lots of things/carry a heavy work load. Cool.

Ive met several people that feel overworked/underpaid as a junior, that seems increasingly common unfortunately. But for some, the trigger to change jobs came because the partnership did not seem "worth it" when they started to be eligible for promotion. I have to be honest that some of the few partnership offers Ive heard about in detail seem bizarre and shady. I still dont understand why people have to buy in to a PC only practice haha.

That practice culture was never for me so I have no personal experience. Just find all that interesting 🤷‍♂️

I am hearing about some corperate-y jobs offering really high base salaries with good vacation/admin days. Pros and cons to every job but I suspect it may be hard to compete with that for a lot of graduates (for now, in this market, if it lasts)

 

[MidwestRadOnc]

I don’t know about sero, but I have seen another place that had a 5M buy in after 2 years of 300k-ish, and tech and real estate was split about a dozen ways with other specialities. I’m not even sure it was real mainly just to scare away people from asking, since the math worked out to probably at least 10 years maybe 15 to recoup that.

Another with 8 year track clawing your way slowly from 400 to 800.

So yeah, not worth it.
Nobody voluntarily gives up their piece of the pie without an exorbitant cost in my experience. It’s a secret club and you’re not in it without a family connection.

ASTRO job board sucks. Honestly it’s a red flag to me if a job is posted there.

 

[OTN]

I don’t know about sero, but I have seen another place that had a 5M buy in after 2 years of 300k-ish, and tech and real estate was split about a dozen ways with other specialities. I’m not even sure it was real mainly just to scare away people from asking, since the math worked out to probably at least 10 years maybe 15 to recoup that.

Another with 8 year track clawing your way slowly from 400 to 800.

So yeah, not worth it.
Nobody voluntarily gives up their piece of the pie without an exorbitant cost in my experience. It’s a secret club and you’re not in it without a family connection.

ASTRO job board sucks. Honestly it’s a red flag to me if a job is posted there.

Some practices do have equitable distribution and partnership agreements, but it's getting rarer I agree, unfortunately.

$5M buy-in is bananas unless the real estate is super valuable, and even then the devil is indeed in the details.

 

[Gfunk6]

ASTRO job board sucks. Honestly it’s a red flag to me if a job is posted there.

Back in the day, I had the ASTRO job board bookmarked on my browser. Though I had no real interest in new jobs, I always found it interesting and useful to see what was out there. There was no login and the info was presented in a straightforward way that was easily sorted or filtered.

Once they mandated log in every single time and changed the formatting of postings, it became a chore. I haven't looked at the job board in over a year now.

 

[Fpg1245]

SERO guy had some interesting stuff to say at the ARRO day panel I was on. He said they liked to look for residents that do a lot of research because it speaks to them being able to juggle lots of things/carry a heavy work load. Cool.

Ive met several people that feel overworked/underpaid as a junior, that seems increasingly common unfortunately. But for some, the trigger to change jobs came because the partnership did not seem "worth it" when they started to be eligible for promotion. I have to be honest that some of the few partnership offers Ive heard about in detail seem bizarre and shady. I still dont understand why people have to buy in to a PC only practice haha.

That practice culture was never for me so I have no personal experience. Just find all that interesting 🤷‍♂️

I am hearing about some corperate-y jobs offering really high base salaries with good vacation/admin days. Pros and cons to every job but I suspect it may be hard to compete with that for a lot of graduates (for now, in this market, if it lasts)

They like people with a lot of research because it displays a willingness to provide free work. Why would they have to offer partnership now?

they can get the same young pathological overachievers on the cheap!

SERO is good for the old guard but once they’re gone they’ll either sell it or allow the hospital to take it over.

In todays climate, I don’t think joining models like SERO are something new grads should aspire to

 

[fiji128]

Looking forward to some 2024 updates

I will try and get on it next week. As stated above the board is a mess and there is no easy way to just get actual MD rad onc jobs so it has to be gone through by hand and typed up one by one.

I applied to that Grand Junction CO job but never heard anything back. Suspect many of these listing that you see over and over are about the same.

 

[NotMattSpraker]

They like people with a lot of research because it displays a willingness to provide free work. Why would they have to offer partnership now?

they can get the same young pathological overachievers on the cheap!

SERO is good for the old guard but once they’re gone they’ll either sell it or allow the hospital to take it over.

In todays climate, I don’t think joining models like SERO are something new grads should aspire to

I dont think so either, but aspirations are so personal and subjective. I really like that there is a wide range of models and options for people (at least this year).

I just wish we didnt flood the job market so bad jobs can live off cycling new grads.

 

[medgator]

Back in the day, I had the ASTRO job board bookmarked on my browser. Though I had no real interest in new jobs, I always found it interesting and useful to see what was out there. There was no login and the info was presented in a straightforward way that was easily sorted or filtered.

Once they mandated log in every single time and changed the formatting of postings, it became a chore. I haven't looked at the job board in over a year now.

This x1000. Also requiring membership to see the newest jobs first etc

 

[Mandelin Rain]

I dont think so either, but aspirations are so personal and subjective. I really like that there is a wide range of models and options for people (at least this year).

I just wish we didnt flood the job market so bad jobs can live off cycling new grads.

Man, I think physician ownership of their business/money/healthcare is something all physicians should constantly aspire to.

YMMV

 

[thecarbonionangle]

I still do not think we have a healthy job market. True PP opportunities with a clear path to partnership are hard to come by. There are practices in major cities cycling new grads every 3-5 years and keep finding a new sucker based on location and never offer partnership. Middle of nowhere academic “satellites” fill, formerly high paying PP jobs now average pays job in a bad location. The myth of the secret jobs persists. It is no wonder everyone will eventually be employed, probably working for optum being squeezed.

If you are matching into hellpits at this time, you will have nobody to blame but yourself. The future is not bright.

 

[Neuronix]

Looking forward to some 2024 updates

I will try and get on it next week. As stated above the board is a mess and there is no easy way to just get actual MD rad onc jobs so it has to be gone through by hand and typed up one by one.

I applied to that Grand Junction CO job but never heard anything back. Suspect many of these listing that you see over and over are about the same.

Back when I was job searching, my response rate applying to posted jobs was on the order of ~10-20% depending on the year. So, clearly these posted jobs are not desperate. A lot of the posted jobs are not real (i.e. they want a very specific candidate and will wait or the position was posted but they're not sure if they're hiring) or already filled before being posted (this happens a lot in academics).

I will grant that the job market right now seems better than it was pre-COVID and during COVID. I knew some desperate, unemployed, and underemployed rad oncs back then. I hope we don't get back there. Back then, anything posted on those job sites would get dozens of applications from qualified people, and it was actually a struggle to sort through them all. Yeah, the best jobs did fill through "word of mouth" since good practices and academic places were often getting dozens of unsolicited applications per year. People still complain about how often they get contacted by job seekers unsolicited.

The good news is that I can't give you sob stories currently--everyone I know seems to be employed and reasonably content at various hospital employed or academic satellite positions somewhere in the range of reasonable MGMA numbers (except for some new grads and some known to be bad urban locations). Sure, a lot of people are looking because good luck having any preference about what you want in a job (location, job parameters, lifestyle, etc), and sometimes not living in a location preference or having the type of rad onc job desired remains an issue even if when fully employed at a reasonable salary.

Almost no other medical specialty is like this. The med oncs where I trained got job offers at double what I was being offered and were being recruited from the day they set foot into fellowship. But, if you're coming into rad onc knowing how bad things are and expecting the worst, things may not seem so bad now that it is well known how bad the job market is and things have mildly improved.

I do know one malignant academic place that got so short staffed they were forced to improve conditions and salaries or they were at risk of shutting down satellites. Supply and demand rules this labor market.

 

[elementaryschooleconomics]

Back when I was job searching, my response rate applying to posted jobs was on the order of ~10-20% depending on the year. So, clearly these posted jobs are not desperate. A lot of the posted jobs are not real (i.e. they want a very specific candidate and will wait or the position was posted but they're not sure if they're hiring) or already filled before being posted (this happens a lot in academics).

I will grant that the job market right now seems better than it was pre-COVID and during COVID. I knew some desperate, unemployed, and underemployed rad oncs back then. I hope we don't get back there. Back then, anything posted on those job sites would get dozens of applications from qualified people, and it was actually a struggle to sort through them all. Yeah, the best jobs did fill through "word of mouth" since good practices and academic places were often getting dozens of unsolicited applications per year. People still complain about how often they get contacted by job seekers unsolicited.

The good news is that I can't give you sob stories currently--everyone I know seems to be employed and reasonably content at various hospital employed or academic satellite positions somewhere in the range of reasonable MGMA numbers (except for some new grads and some known to be bad urban locations). Sure, a lot of people are looking because good luck having any preference about what you want in a job (location, job parameters, lifestyle, etc), and sometimes not living in a location preference or having the type of rad onc job desired remains an issue even if when fully employed at a reasonable salary.

Almost no other medical specialty is like this. The med oncs where I trained got job offers at double what I was being offered and were being recruited from the day they set foot into fellowship. But, if you're coming into rad onc knowing how bad things are and expecting the worst, things may not seem so bad now that it is well known how bad the job market is and things have mildly improved.

I do know one malignant academic place that got so short staffed they were forced to improve conditions and salaries or they were at risk of shutting down satellites. Supply and demand rules this labor market.

At the end of the day, all anyone needs to know is that the "Oversupply Deniers" consistently cite one datapoint to support their argument:

"There is low unemployment!" (as reported by a survey of PGY-5 residents completed primarily 1-2 months before they even graduate)

That is literally the most pathetic metric one can imagine. Even if the source was rock solid, as in, a comprehensive database maintained quarterly by an independent organization, there is almost no other specialty where the strength of the job market is judged by physician unemployment.

It's insane.

 

[NotMattSpraker]

I still do not think we have a healthy job market.

Oh huh. I guess neither do the medical students or the ASTRO yes-people.

 

[Chartreuse Wombat]

Oh huh. I guess neither do the medical students or the ASTRO yes-people.

View attachment 382261

View attachment 382260

Response rate 27%. Stopped reading. No meaningful inference possible

 

[communitydoc13]

Oh huh. I guess neither do the medical students or the ASTRO yes-people.

View attachment 382261

View attachment 382260

Said here first! (well maybe). I'd like to think that SDN convos helped prompt this work.

Response rate 27%. Stopped reading. No meaningful inference possible

I think it depends on the goal of the survey.

If the goal of the survey is to get meaningful salary data, 27% is a problem.

If the goal is to gauge whether there is interest in a paradigm change regarding training options, 27% is fine.

Most surveys have low response rates.

Clearly there is an interest.

 

[Ray D. Ayshun]

Said here first! (well maybe). I'd like to think that SDN convos helped prompt this work.

I think it depends on the goal of the survey.

If the goal of the survey is to get meaningful salary data, 27% is a problem.

If the goal is to gauge whether there is interest in a paradigm change regarding training options, 27% is fine.

Most surveys have low response rates.

Clearly there is an interest.

A 27% response rate to a stupid question made me stop reading. More the latter really.

 

[MidwestRadOnc]

At the end of the day, all anyone needs to know is that the "Oversupply Deniers" consistently cite one datapoint to support their argument:

"There is low unemployment!" (as reported by a survey of PGY-5 residents completed primarily 1-2 months before they even graduate)

That is literally the most pathetic metric one can imagine. Even if the source was rock solid, as in, a comprehensive database maintained quarterly by an independent organization, there is almost no other specialty where the strength of the job market is judged by physician unemployment.

It's insane.

Manipulated employment numbers seem to be common everywhere now. We have a robust economy (full of expanded part time jobs and government jobs established with Covid funds)!

It’s obviously bogus when anyone looks at it objectively. Rad onc job market is clearly regional yet we judge the health based on aggregate of the entire country. Honest metrics would include regional data and income relative to actual work performed in a FFS environment.

I also don’t like the term “job market” as we are supposed to be professionals who take ownership of our skills, not hired and easily replaced labor. But that’s wishful thinking I know as that ship has long since sailed.

 

[NotMattSpraker]

At the end of the day, all anyone needs to know is that the "Oversupply Deniers" consistently cite one datapoint to support their argument:

"There is low unemployment!" (as reported by a survey of PGY-5 residents completed primarily 1-2 months before they even graduate)

That is literally the most pathetic metric one can imagine. Even if the source was rock solid, as in, a comprehensive database maintained quarterly by an independent organization, there is almost no other specialty where the strength of the job market is judged by physician unemployment.

It's insane.

Its worse than that. We aren't even having a real conversation anymore. Some tried to do a real conversation, ASTRO quashed it, and all those folks decided their roles in ASTRO were more important than this discussion.

I do not blame anyone. It may never be the right thing to sacrifice your role or position... indirectly your career... for some cause.

That said, I dont think there is anyone left inside these organizations that is willing to do that for ANY cause.

The deck is so stacked against any kind of change, the workforce discussion is done.

I feel sorry that some places have already shown they are totally cool for their faculty to be a rotating cast of new grads that stay <3 years.

Have fun.

 

[Mandelin Rain]

Are you describing ASTRO or a certain political party? Hard to tell.

 

[communitydoc13]

A 27% response rate

5-30%...that's a good response rate for a survey regarding a brand

I'm just saying...I think the response rate is fine here and reflects a general attitude among prospective radiation oncologists that many of them would prefer it be integrated in a larger oncology role

Smart kids

 

[Ray D. Ayshun]

5-30%...that's a good response rate for a survey regarding a brand

I'm just saying...I think the response rate is fine here and reflects a general attitude among prospective radiation oncologists that many of them would prefer it be integrated in a larger oncology role

Smart kids

I like the idea. But now that I'm actually doing this, I don't have any interest in this concept. It would be better to come up with a way to allow us to do more of what we already do than to give us more diverse responsibilities. Like addressing the supply side. This sounds like a recipe for disaster. I do consider this profession somewhat of a calling, but ultimately, I'm working to live and not vice versa. Based on what I know now, I would have zero interest in my thoughts on this matter as a med student, or even a resident.

 

[communitydoc13]

Like addressing the supply side.

Absolutely. I also believe that big academic radonc is responding to the pinch in interest, prestige and indications by looking for any solution other than a supply side one.

 

[NotMattSpraker]

I like the idea. But now that I'm actually doing this, I don't have any interest in this concept. It would be better to come up with a way to allow us to do more of what we already do than to give us more diverse responsibilities. Like addressing the supply side. This sounds like a recipe for disaster. I do consider this profession somewhat of a calling, but ultimately, I'm working to live and not vice versa. Based on what I know now, I would have zero interest in my thoughts on this matter as a med student, or even a resident.

Im basically now telling every single Rad Onc dedicated trainee/applicant that they should keep a very open mind and seek out opportunities to build some additional skills relevant to a hospital. If that skill requires you to pay or train for free, be very discerning about the outcome. Sometimes it makes sense, but its often just more abuse.

We are set up really well to do all kinds of things; quality, informatics, administration, marketing, teaching. We have time at work and in training to develop skills, we are trained on management of almost all cancers, and more physicians in hospital leadership is great for everyone.

The only thing you can come up with is to do more residency training or combined residency training? Please... PLEASE... take 3 steps outside your academic office and go talk to some real life oncologists.

 

[Mandelin Rain]

Does anyone have a sense of how the current crop of "post-peak" residents are doing in residency? Is it a disaster? Adding responsibility seems like a good idea until it's not.

 

[RadRadRad]

Combined IM-RO
How long is that? 7 years?
That would help the job market tremendously. Make it the only path. There will be no grads for 2 years and some of those grads will go on to do something else!

 

[medgator]

Combined IM-RO
How long is that? 7 years?
That would help the job market tremendously. Make it the only path. There will be no grads for 2 years and some of those grads will go on to do something else!

Really helped in the 90s when they extended training a year and no graduated.

Now they simply DGAF

 

[NotMattSpraker]

Combined IM-RO
How long is that? 7 years?
That would help the job market tremendously. Make it the only path. There will be no grads for 2 years and some of those grads will go on to do something else!

LOL combined medicine RO could have the most nuanced, irrelevant pimping in all of medicine.

"What was the grade 3 toxicity rate in RTOG 1112, and also, please recite the molecular pathway underlying liver fibrosis. Choose your words carefully because if you are wrong you are a horrible person." -You know who this is

 

[Ray D. Ayshun]

Absolutely. I also believe that big academic radonc is responding to the pinch in interest, prestige and indications by looking for any solution other than a supply side one.

Right, this paper seems to be a product of the false choice we are being given by academic radons. I'm cool with my lame ass photon scalpel. This is the job. Help me do the job better, don't make it a different job.

 

[elementaryschooleconomics]

Does anyone have a sense of how the current crop of "post-peak" residents are doing in residency? Is it a disaster? Adding responsibility seems like a good idea until it's not.

I'm having a hard time getting a read on things these days.

There doesn't appear to be a cohesive, centralized social media source for RadOnc like there used to be. In the pre-crash (2018) days, SDN was...well, SDN, and Twitter was where the legacy #RaRaRadOnc crowd could strut like peacocks.

We had the 2019-2021 era, where there was open, non-anonymous pushback against the establishment narrative.

But at least the old guard was still visible. After the combination of losing the narrative war and the shakeup of the Elon acquisition, a lot of legacy RadOncs disappeared.

Honestly, it seems like everyone is just trying to slog through the mess that is Healthcare right now. It's probably impossible to tease out lower performing residents from just...lower performing systems.

 

[communitydoc13]

Combined IM-RO
How long is that? 7 years?

So much inefficiency and labor capture at all levels of MD training. Where I went to med school, Gen Surg spent like 7 years, including obligatory 2 year research...dumb AF for most residents. Residents providing call coverage throughout of course.

4 years plus intern year for clinical radonc? Low value...but did momentarily help job market 2 generations ago.

3rd year of IM medicine in most academic programs? Low value...unless you are going to spend your career in medical ICUs of some flavor.

IMO:

RO should be 3-4y including intern year (Holman's often go clinical presently). Research fellowships optional. Brachy fellowship (6 mos to 1 year) mandatory for brachytherapists.

HO should be 5-6y total depending on research aspirations. (2y clinical HO fellowship) Additional fellowship for transplant obviously.

Comprehensive clinical ONC (minus Heme) should be 6 years total, 2 IM, 4 combined RO/MO

Pipe dreams.

Oh and med school...3 years (Duke model), let more in and fail some out.

 

[evilbooyaa]

IM/RO is dumb.

"In comparison to IM/RO, participants were significantly more interested in a combined RO and hematology/oncology program (p=0.0005)"

HO/RO

As is done in much of the rest of the world

That's the answer we're looking for

That's the answer the students are looking for.

But, it will be ignored in favor of IM/RO. We gonna shorten one? Or we talking about 7 years of residency?? 10 years if you wanna do RO/HO?