Dare you to reply!

[RickyScott]

A couple of things

1) I can't wait until Reshma Jagsi has to point out actual real life people, not imaginary "white men" to bring down. She needs to WALK THE WALK in her own dept. before trying to clean up the rest of the world. FIRE YOUR OWN WHITE MALE CHAIR WHO HAS BEEN THERE A LONG TIME. Oh btw, see some other random who cares b/c they are white males under Theodore Lawrence as well on their website


View attachment 283571

2) Dr. Jagsi keeps harping about URMs - UNDER represented minorities. SHE IS ASIAN/INDIAN = OVER REPRESENTED minority. Be consistent and apply your own rules to YOURSELF. Bonus How long have you kept your deputy chair position? Isn't time for you to move over for a true URM.

Mind you there are only 2-3% Jews in the population and 6-7% Asians, but I believe these groups make up 10-15% and 20-25%, respectively. Dr. Jagsi tell us how much is too much? Perhaps you can just ask your alma mater / Harvard for advice.

3) I have been saying here for a while, this is eventually going to spill over into the patient doctor relationship. I am not looking forward to the day when patient's ask for a white, black, Asian, Hispanic, Muslim, Jewish, etc. doctor that best matches their own identity. Following on the heals of this will be those who will want to ask on ideological basis. Politics is destroying everything why should the patient-doctor relationship be spared?

Virtue Signalling at its worst. Bringing disadvantaged minorities into radiation is not doing them any favors. (and having them work in MAGA country due to inherent geographic restrictions of the field is just what they signed up for).

---

Members don't see this ad.

 

[scarbrtj]

A couple of things

1) I can't wait until Reshma Jagsi has to point out actual real life people, not imaginary "white men" to bring down. She needs to WALK THE WALK in her own dept. before trying to clean up the rest of the world. FIRE YOUR OWN WHITE MALE CHAIR WHO HAS BEEN THERE A LONG TIME. Oh btw, see some other random who cares b/c they are white males under Theodore Lawrence as well on their website


View attachment 283571

2) Dr. Jagsi keeps harping about URMs - UNDER represented minorities. SHE IS ASIAN/INDIAN = OVER REPRESENTED minority. Be consistent and apply your own rules to YOURSELF. Bonus How long have you kept your deputy chair position? Isn't time for you to move over for a true URM.

Mind you there are only 2-3% Jews in the population and 6-7% Asians, but I believe these groups make up 10-15% and 20-25%, respectively. Dr. Jagsi tell us how much is too much? Perhaps you can just ask your alma mater / Harvard for advice.

3) I have been saying here for a while, this is eventually going to spill over into the patient doctor relationship. I am not looking forward to the day when patient's ask for a white, black, Asian, Hispanic, Muslim, Jewish, etc. doctor that best matches their own identity. Following on the heals of this will be those who will want to ask on ideological basis. Politics is destroying everything why should the patient-doctor relationship be spared?

When starting the article with

Several explanations have been proposed for the “leaky pipeline”...

Thought maybe it was going to be a BPH or prostate cancer tie-in. Not. Well maybe. In a way.

 

[Mandelin Rain]

When starting the article with

Several explanations have been proposed for the “leaky pipeline”...

Thought maybe it was going to be a BPH or prostate cancer tie-in. Not. Well maybe. In a way.

Perhaps you're on to something. Chairmen must retire when AUA score is >10. Out with those old men!

 

[thecarbonionangle]

The question is, is it better for a black/hispanic person, the URM, to avoid rad onc all together? On one hand its a six figure salary with a decent salary to work ratio allowing time for family. Other fields offer good salaries as well, though not the same QOL. The possibility of ending up in rural WV for a disadvantaged minority ends up being a personal one. These areas have a lot of good people who need help and care but the thought of being in MAGA country for a URM is understandably for some scary. I think we have to highlight the pros and cons honestly to people no matter who they are and let the canaries decide. Some may say they already have and Mayo will reap the seeds of their deeds. We shall see!!!

 

[RadOncMegatron]

The question is, is it better for a black/hispanic person, the URM, to avoid rad onc all together? On one hand its a six figure salary with a decent salary to work ratio allowing time for family. Other fields offer good salaries as well, though not the same QOL. The possibility of ending up in rural WV for a diasdvantaged minority ends up being a personal one. These areas have a lot of good people who need help and care but the thought of being in MAGA country for a URM is understandably for some scary. I think we have to highlight the pros and cons honestly to people no matter who they are and let the canaries decide. Some may say they already have and Mayo will reap the seeds of their deeds. We shall see!!!

The other question that follows from this is if rural areas need more radiation oncologists and most of the people in those areas are white... shouldn't they actively recruit more white people? Maybe it's a bad look to say "Hey we want white people, but only for the rural areas."

Lose / Lose situation here...

 

[Mandelin Rain]

This is all getting very confusing.

 

[radoncgrad2019]

Seems like some on this forum and those on #radonc Twitter can't seem to figure out that difference.

Term limits for people in charge are a good thing. Our field would be improved with that. The old out of touch chairs that we don't like would be forced to give up their power.

don't get caught up on the race/gender stuff if you find that triggering, because some of you clearly do.

point is - TERM LIMITS.

 

[KHE88]

A couple of things

1) I can't wait until Reshma Jagsi has to point out actual real life people, not imaginary "white men" to bring down. She needs to WALK THE WALK in her own dept. before trying to clean up the rest of the world. FIRE YOUR OWN WHITE MALE CHAIR WHO HAS BEEN THERE A LONG TIME. Oh btw, see some other random who cares b/c they are white males under Theodore Lawrence as well on their website


View attachment 283571

2) Dr. Jagsi keeps harping about URMs - UNDER represented minorities. SHE IS ASIAN/INDIAN = OVER REPRESENTED minority. Be consistent and apply your own rules to YOURSELF. Bonus How long have you kept your deputy chair position? Isn't time for you to move over for a true URM.

Mind you there are only 2-3% Jews in the population and 6-7% Asians, but I believe these groups make up 10-15% and 20-25%, respectively. Dr. Jagsi tell us how much is too much? Perhaps you can just ask your alma mater / Harvard for advice.

3) I have been saying here for a while, this is eventually going to spill over into the patient doctor relationship. I am not looking forward to the day when patient's ask for a white, black, Asian, Hispanic, Muslim, Jewish, etc. doctor that best matches their own identity. Following on the heals of this will be those who will want to ask on ideological basis. Politics is destroying everything why should the patient-doctor relationship be spared?

Exactly. My rant was moreso a general frustration in response to the culture in general rather than a direct critique of the article.
The point is that this nonesense is harmful and has no place in evidence based medicine (or anywhere really).
It is incredibly frustrating that the NEJM continues to publish these types of articles with this pervasive motif of there being something inherently rotten about leaders being white, male, old, or a combination of any of the above. Position should be based on MERIT alone and judged on a case-by-case basis.
There is a reason there is a male majority in radiation oncology and it is NOT because men are systematically conspiring to keep women out! The reason is that female medical students are, for whatever reason, not choosing of their free will to go into this field. This is nothing inherently wrong with this. Men and women are different. On the whole, they naturally gravitate to different fields. One is not better than the other! If a woman wants to be a rad onc, I am all for it! If a man wants to be a ob/gyn, I am all for it! Can we stop playing these games and imagining victimhood?

Honestly, how many resources have been wasted pursuing this "research" into supposed gender inequality in medicine? We have people creating entire academic careers on this silliness rather than, you know, researching actual medicine or focusing on practicing actual medicine. Community physicians at satellites are having an ever-growing portion of the income they generate with their work funneled back to the main center to support the "research" endeavors of the academics, and this is the result?

It is no surprise that those aspiring to be future leaders in the field are constantly virtue signalling on twitter and publishing these soft articles rather than truly trying to advance the field forward with real research. It is also funny that as you point out, they tend to be women (who comprise the majority of medical students these days) and/or over-represented minorities. Yes, they are obviously being systematically shut out by the evil old white boogey-man. Lets spend millions on grants and thousands of physician hours to keep filling the NEJM with these articles.

Stop making everything about oppression from the patriarchy based skin color, sex, sexuality, religion. If there's a problem with the leaders, make a real evidence-based argument on a CASE BY CASE BASIS.

 

[RadOncMegatron]

Exactly. My rant was moreso a general frustration in response to the culture in general rather than a direct critique of the article.
The point is that this nonesense is harmful and has no place in evidence based medicine (or anywhere really).
It is incredibly frustrating that the NEJM continues to publish these types of articles with this pervasive motif of there being something inherently rotten about leaders being white, male, old, or a combination of any of the above. Position should be based on MERIT alone and judged on a case-by-case basis.
There is a reason there is a male majority in radiation oncology and it is NOT because men are systematically conspiring to keep women out! The reason is that female medical students are, for whatever reason, not choosing of their free will to go into this field. This is nothing inherently wrong with this. Men and women are different. On the whole, they naturally gravitate to different fields. One is not better than the other! If a woman wants to be a rad onc, I am all for it! If a man wants to be a ob/gyn, I am all for it! Can we stop playing these games and imagining victimhood?

Honestly, how many resources have been wasted pursuing this "research" into supposed gender inequality in medicine? We have people creating entire academic careers on this silliness rather than, you know, researching actual medicine or focusing on practicing actual medicine. Community physicians at satellites are having an ever-growing portion of the income they generate with their work funneled back to the main center to support the "research" endeavors of the academics, and this is the result?

It is no surprise that those aspiring to be future leaders in the field are constantly virtue signalling on twitter and publishing these soft articles rather than truly trying to advance the field forward with real research. It is also funny that as you point out, they tend to be women (who comprise the majority of medical students these days) and/or over-represented minorities. Yes, they are obviously being systematically shut out by the evil old white boogey-man. Lets spend millions on grants and thousands of physician hours to keep filling the NEJM with these articles.

Stop making everything about oppression from the patriarchy based skin color, sex, sexuality, religion. If there's a problem with the leaders, make a real evidence-based argument on a CASE BY CASE BASIS.

This thing has no end in sight (esp. with the MCAT having a psycho/social part)! Dr. Chowdhary seems like a good guy, but the self-referential blindness & hypocrisy is crazy. An Asian/Indian male has been awarded a fellowship for gender equity? If you really believe what you believe have the decency to give this to a female minority - my goodness!

 

[RadOncMegatron]

Term limits for people in charge are a good thing. Our field would be improved with that. The old out of touch chairs that we don't like would be forced to give up their power.

don't get caught up on the race/gender stuff if you find that triggering, because some of you clearly do.

point is - TERM LIMITS.

Did you read the article? The point is NOT term limits.

"Yet there is another distinct and clearly modifiable contributing factor that has yet to garner attention within academic medicine: the lack of term limits for senior leaders, whose numbers remain disproportionately white and male "

"Finally — and perhaps most important — diversity improves patient care. Black patients elect to receive more preventive services when they have black physicians than when they have nonblack physicians3; female patients are less likely to die after a heart attack when they are treated by female physicians than when they are treated by male physicians4; and physicians who are members of underrepresented groups are more likely than white, male physicians to serve minority, poor, and Medicaid populations.5 Promoting women and underrepresented minorities to leadership positions may well enable academic medicine to better serve our diverse population."

If the point was term limits I would agree with you, but let's not pretend there is no other agenda here.

 

[KHE88]

This thing has no end in sight (esp. with the MCAT having a psycho/social part)! Dr. Chowdhary seems like a good guy, but the self-referential blindness & hypocrisy is crazy. An Asian/Indian male has been awarded a fellowship for gender equity? If you really believe what you believe have the decency to give this to a female minority - my goodness!

As long as he apologizes for being a man and an over-represented ethnic group, it's forgiveable.

 

[medgator]

It is incredibly frustrating that the NEJM continues to publish these types of articles

Bingo. Literally at the top of the TOC, which is why it caught my eye and why I posted it here.

Can't remember the last decent XRT study published in nejm, seems like it is all prostate drugs and immunotherapy these days there

 

[deleted1002574]

You all are right, mostly. But why is it such a big deal to you?

When you engage with such vigor it starts justifying the nonsense.

I'm just curious why the majority voice (which I'd be a part of) is the voice that is rejecting/upset about this. Even though a lot of what they are talking about is, frankly, nonsense, when the majority voice fusses so much about it, it just comes off ... as odd.

Like, when women or black people (or whoever - just using at as an example) were trying to break barriers, it was the majority voices that were the ones that were angry / upset.

I'm just curious to see where this is leading and what the fight you're fighting is really about.

What about this?

When women performed speaker introductions, no gender differences in professional address were observed (75% v 82%; P = .13). Female speakers were more likely to be introduced by first name only (17% v 3%; P < .001). Male introducers were more likely to address female speakers by first name only compared with female introducers (24% v 7%; P < .01). In a multivariable regression including gender, degree, academic rank, and geographic location of the speaker’s institution, male speakers were more likely to receive a professional address compared with female speakers (odds ratio, 2.43; 95% CI, 1.71 to 3.47; P < .01).

I do want it be known - I agree with your points - but the vociferousness about this ... it just makes me curious. For example, if men do appear to take women more casually, use their first names, don't address women's female rank in a conference setting when people are watching, what makes you think they aren't doing the same thing behind closed doors when making decisions.

I'm sure I'll be attacked (even as someone represented heavily disproportionately by my gender/ethnicity), but just curious about what you really are saying. It's a very defensive stance from a group of people who, perhaps, maybe don't need to play defense?

 

[radoncgrad2019]

You all are right, mostly. But why is it such a big deal to you?

When you engage with such vigor it starts justifying the nonsense.

I'm just curious why the majority voice (which I'd be a part of) is the voice that is rejecting/upset about this. Even though a lot of what they are talking about is, frankly, nonsense, when the majority voice fusses so much about it, it just comes off ... as odd.

Like, when women or black people (or whoever - just using at as an example) were trying to break barriers, it was the majority voices that were the ones that were angry / upset.

I'm just curious to see where this is leading and what the fight you're fighting is really about.

What about this?

When women performed speaker introductions, no gender differences in professional address were observed (75% v 82%; P = .13). Female speakers were more likely to be introduced by first name only (17% v 3%; P < .001). Male introducers were more likely to address female speakers by first name only compared with female introducers (24% v 7%; P < .01). In a multivariable regression including gender, degree, academic rank, and geographic location of the speaker’s institution, male speakers were more likely to receive a professional address compared with female speakers (odds ratio, 2.43; 95% CI, 1.71 to 3.47; P < .01).

I do want it be known - I agree with your points - but the vociferousness about this ... it just makes me curious. For example, if men do appear to take women more casually, use their first names, don't address women's female rank in a conference setting when people are watching, what makes you think they aren't doing the same thing behind closed doors when making decisions.

I'm sure I'll be attacked (even as someone represented heavily disproportionately by my gender/ethnicity), but just curious about what you really are saying. It's a very defensive stance from a group of people who, perhaps, maybe don't need to play defense?

exactly.

 

[xrthopeful]

This anger is not exactly helping the characterization of SDN as a 4Chan-lite type place

 

[KHE88]

You all are right, mostly. But why is it such a big deal to you?



I'm sure I'll be attacked (even as someone represented heavily disproportionately by my gender/ethnicity), but just curious about what you really are saying. It's a very defensive stance from a group of people who, perhaps, maybe don't need to play defense?

Because the in-your-face implication is that simply because I am some combination of:

- White or ORM
- Male
- Old

Then I must be inherently racist and/or sexist. I most certainly am not, and yes it makes me very mad that this gaslighting is going on to such a scale that it has permeated every facet of society. And I'm going to defend myself.

This anger is not exactly helping the characterization of SDN as a 4Chan-lite type place

This is a straight up ad hominem. Agree with the wokeness or else you're a 4chan nazi. Forget about rising through the ranks, lets doxx you, drag your name through the mud, and get you fired if you don't agree with everything and apologize for your skin color or genitals or whatever else the Twitter mob says you've victimized people with. This is their M.O. It's happening and it's scary.

 

[deleted1002574]

But @KHE88, its is ad-hominem to say you are because you are white/male/old that "everyone" thinks you're racist/sexist. I don't. I don't think most people on this board do. I don't think Dr. Jagsi does (I don't know her). I think you're probably a good person with a good heart that does good things - like most people I encounter (except the leadership of ASTRO and the ABR, they are monsters).

The implication isn't that you are racist/sexist. That's not how I read that, at all.

If it is true (and I'm not claiming with certainty that it is) that that JCO article is correct, does that mean: 1) nothing 2) something 3) everything? It appears you think the Dr. Jagsi's of the world say it is #3. Maybe they think that you think that it's #1... when more likely it is #2.

Again, the same argument you're making can be made back if you inherently assume the worst in people (like you think they do to you).

 

[medgator]

This anger is not exactly helping the characterization of SDN as a 4Chan-lite type place

Really? Who's characterizing it as such? Seems like a pretty off the wall and malicious accusation of this forum imo.

And, if so, Why are you still here in that case?

I'm almost tempted to MA your post as trolling, personally

 

[xrthopeful]

to be fair, I don't think SDN is like 4Chan. That place is way way way way worse, and this place can be quite good at times.

BUT, the comparison was made just a few days ago in the med student thread, by one of the most reasonable regular posters here:

medstudents entering the match

Have to give their society kudos for releasing that spring statement. Thats the kind of leadership our field is lacking. https://journals.lww.com/em-news/pages/articleviewer.aspx?year=2019&issue=10000&article=00001&type=Fulltext What a real editorial looks like. Compare that to the PW/LK...

forums.studentdoctor.net

I'm almost tempted to laugh at you being tempted to report me LMAO

 

[RadOncMegatron]

You all are right, mostly. But why is it such a big deal to you?

When you engage with such vigor it starts justifying the nonsense.

I'm just curious why the majority voice (which I'd be a part of) is the voice that is rejecting/upset about this. Even though a lot of what they are talking about is, frankly, nonsense, when the majority voice fusses so much about it, it just comes off ... as odd.

Like, when women or black people (or whoever - just using at as an example) were trying to break barriers, it was the majority voices that were the ones that were angry / upset.

I'm just curious to see where this is leading and what the fight you're fighting is really about.

What about this?

When women performed speaker introductions, no gender differences in professional address were observed (75% v 82%; P = .13). Female speakers were more likely to be introduced by first name only (17% v 3%; P < .001). Male introducers were more likely to address female speakers by first name only compared with female introducers (24% v 7%; P < .01). In a multivariable regression including gender, degree, academic rank, and geographic location of the speaker’s institution, male speakers were more likely to receive a professional address compared with female speakers (odds ratio, 2.43; 95% CI, 1.71 to 3.47; P < .01).

I do want it be known - I agree with your points - but the vociferousness about this ... it just makes me curious. For example, if men do appear to take women more casually, use their first names, don't address women's female rank in a conference setting when people are watching, what makes you think they aren't doing the same thing behind closed doors when making decisions.

I'm sure I'll be attacked (even as someone represented heavily disproportionately by my gender/ethnicity), but just curious about what you really are saying. It's a very defensive stance from a group of people who, perhaps, maybe don't need to play defense?

I acknowledge your point. Part of the problem is there is no mechanism to disagree on these topics without fear of, as you note, vociferous retribution. Too many examples where even trying to broach this problem in a reasonable manner. Also, the furor comes about due to the overwhelming, disproportionate, influence, and power of this group.

1) They were able to change the MCAT
2) They are making ASCO guildelines based on race
3) Given positions of power within the univ (office of Diversity, Equity, & Inclusion)
4) Allowed to publish unilateral opinions in the foremost medical journal
5) College admission and even attending positions (ie UCSD) ask about how you can contribute to diversity

The passion comes about from the complete abuse reckoned onto the medical system by those that promote this ideology. They don't simply have an abstract here or there and invite all to come for a discussion. They control the narrative and have nearly all the seats of power. I believe someone on ROHub tried to have a discussion only to have it shut down by the chair of ASTRO at the time?

 

[xrthopeful]

I acknowledge your point. Part of the problem is there is no mechanism to disagree on these topics without fear of, as you note, vociferous retribution. Too many examples where even trying to broach this problem in a reasonable manner. Also, the furor comes about due to the overwhelming, disproportionate, influence, and power of this group.

1) They were able to change the MCAT
2) They are making ASCO guildelines based on race
3) Given positions of power within the univ (office of Diversity, Equity, & Inclusion)
4) Allowed to publish unilateral opinions in the foremost medical journal
5) College admission and even attending positions (ie UCSD) ask about how you can contribute to diversity

The passion comes about from the complete abuse reckoned onto the medical system by those that promote this ideology. They don't simply have an abstract here or there and invite all to come for a discussion. They control the narrative and have nearly all the seats of power. I believe someone on ROHub tried to have a discussion only to have it shut down by the chair of ASTRO at the time?

which one of these 5 things that 'THEY' did really bothers you? sure you can say things like having a 'Dean of Diversity' seem to be like checking a box and empty gestures, but they don't really cause much harm. If you ask me it's all just under the general category of HR whatever.

Some things like continued improvement of standardizes tests are good for everyone.

 

[medgator]

. I believe someone on ROHub tried to have a discussion only to have it shut down by the chair of ASTRO at the time?

Not sure which discussion you are referring to do but I do recall one with the guy from Michigan point blank stating discrimination doesn't exist against URMs anymore which obviously isn't true either

 

[medgator]

to be fair, I don't think SDN is like 4Chan. That place is way way way way worse, and this place can be quite good at times.

BUT, the comparison was made just a few days ago in the med student thread, by one of the most reasonable regular posters here:

medstudents entering the match

Have to give their society kudos for releasing that spring statement. Thats the kind of leadership our field is lacking. https://journals.lww.com/em-news/pages/articleviewer.aspx?year=2019&issue=10000&article=00001&type=Fulltext What a real editorial looks like. Compare that to the PW/LK...

forums.studentdoctor.net

I'm almost tempted to laugh at you being tempted to report me LMAO

Not sure I've agreed with kruk on everything, including that or this.

Either way, it is in poor taste as 4chan/8chan can be pretty nasty from what I've heard

 

[RadOncMegatron]

Not sure which discussion you are referring to do but I do recall one with the guy from Michigan point blank stating discrimination doesn't exist against URMs anymore which obviously isn't true either

Sorry, yea. I prb shouldn't have mentioned that since I actually wasn't privy to the whole conversation.

 

[RadOncMegatron]

which one of these 5 things that 'THEY' did really bothers you? sure you can say things like having a 'Dean of Diversity' seem to be like checking a box and empty gestures, but they don't really cause much harm. If you ask me it's all just under the general category of HR whatever.

Some things like continued improvement of standardizes tests are good for everyone.

All of them? I think none of those things are improvements, but are great detriments to everyone and it's pretty clear opposing views were not consulted.

 

[deleted1002574]

I acknowledge your point. Part of the problem is there is no mechanism to disagree on these topics without fear of, as you note, vociferous retribution. Too many examples where even trying to broach this problem in a reasonable manner. Also, the furor comes about due to the overwhelming, disproportionate, influence, and power of this group.

1) They were able to change the MCAT
2) They are making ASCO guildelines based on race
3) Given positions of power within the univ (office of Diversity, Equity, & Inclusion)
4) Allowed to publish unilateral opinions in the foremost medical journal
5) College admission and even attending positions (ie UCSD) ask about how you can contribute to diversity

The passion comes about from the complete abuse reckoned onto the medical system by those that promote this ideology. They don't simply have an abstract here or there and invite all to come for a discussion. They control the narrative and have nearly all the seats of power. I believe someone on ROHub tried to have a discussion only to have it shut down by the chair of ASTRO at the time?

1) So, did that hurt any one group? And why? (I don't know the answer). Some changes in standardized testing are warranted.
2) I'm less likely to offer AS to black Americans based partially on data and partially on what I've seen in practice. Men and women are different, too, as someone has said. Seems probable not ideal to not know race/gender/etc. about patients you're treating. Japanese people are different WRT to their lung cancer outcomes.
3) Agree. DUM (too DUM to earn the B)
4) Opinions, by definition, are unilateral. Do you wish for counterpoints being published? I agree with you if you do.
5) Okay. So? The rates of admission for legacy/athletes/dean's friend's etc. are much higher than those that are not. These folks are preferentially of one race. There are certain last names that you see in rad onc that are the same as the last names of premier people in our fields. So maybe instead of just being the daughter of someone who went somewhere should be comparable to saying you have some life experience that you can offer to the school (instead of just donations).

These are some coherent points and some ... Idk ... not as much so.

I'm not comparing the substance, but I'm comparing the anger in the past of the majority voices when major changes were being contemplated. Look at the class pictures at your med school from the 1950s-1960s. You should see some of the arguments about why women were not suited for certain fields. Virginia Apgar was not allowed to become a surgeon, thus she created a specialty. Sad that we let a lot of human capital waste away.

 

[Gfunk6]

I guess I am getting old and out of touch because I get lost with some of the terms that are being thrown around on this thread. For the sake of clarity, I goolged the definitions

Virtue Signaling the action or practice of publicly expressing opinions or sentiments intended to demonstrate one's good character or the moral correctness of one's position on a particular issue.

Gaslighting manipulate (someone) by psychological means into questioning their own sanity.

That is all

 

[RadOncMegatron]

1) So, did that hurt any one group? And why? (I don't know the answer). Some changes in standardized testing are warranted.
2) I'm less likely to offer AS to black Americans based partially on data and partially on what I've seen in practice. Men and women are different, too, as someone has said. Seems probable not ideal to not know race/gender/etc. about patients you're treating. Japanese people are different WRT to their lung cancer outcomes.
3) Agree. DUM (too DUM to earn the B)
4) Opinions, by definition, are unilateral. Do you wish for counterpoints being published? I agree with you if you do.
5) Okay. So? The rates of admission for legacy/athletes/dean's friend's etc. are much higher than those that are not. These folks are preferentially of one race. There are certain last names that you see in rad onc that are the same as the last names of premier people in our fields. So maybe instead of just being the daughter of someone who went somewhere should be comparable to saying you have some life experience that you can offer to the school (instead of just donations).

These are some coherent points and some ... Idk ... not as much so.

I'm not comparing the substance, but I'm comparing the anger in the past of the majority voices when major changes were being contemplated. Look at the class pictures at your med school from the 1950s-1960s. You should see some of the arguments about why women were not suited for certain fields. Virginia Apgar was not allowed to become a surgeon, thus she created a specialty. Sad that we let a lot of human capital waste away.

@ROFallingDown I am answering in good faith here since it seems you are asking in good faith as well.

1) Hurts conservatives. This not neutral see article here called The Politicization of the MCAT "unfortunately, what Kirch in particular seems to want to create is a medical community that aligns as closely as possible with his particular political views—and to insist that future doctors accept those views as settled fact. " You can Google questions on the new section that are only coming from one side of the isle.

2) I agree, based on biology. Whether you are white, Asian, or black physician you should be wise on who to give AS or WBRT for. Let me quote again Dr. Jag

"Finally — and perhaps most important — diversity improves patient care. Black patients elect to receive more preventive services when they have black physicians than when they have nonblack physicians3; female patients are less likely to die after a heart attack when they are treated by female physicians than when they are treated by male physicians4; and physicians who are members of underrepresented groups are more likely than white, male physicians to serve minority, poor, and Medicaid populations.5 Promoting women and underrepresented minorities to leadership positions may well enable academic medicine to better serve our diverse population."

She is saying black patients get better care from black doctors. Females from female doctors. Please follow the logic here. Agree or disagree.

If you as a black woman see a white man for breast cancer (say umm.. Benjamin Smith) they are suggesting you would get worse care? Do you ask for a black female doctor? See official ASCO guidelines here: https://www.asco.org/sites/new-www....delines/documents/2017-diversity-strategy.pdf

This is based on RACE and GENDER. See also the oft quoted study in JCO here https://ascopubs.org/doi/full/10.1200/jco.2015.66.3658

3) We agree

4) Yes, I do. During the 2016 election NEJM asked both Trump and Clinton to write about their healthcare proposals. Only Clinton responded, but at least both candidates were given the opportunity. How is it that nearly all the other editorials are all from the liberal point of view, save for some things I saw on physician assisted suicide?

5) I agree on the legacy issue - that issue is easy. But race based is so much different. That is why I asked point blank - how many is too many Jews, Asians, and Indians? Harvard has received blowback for keeping the number Jews in the past and Asians now.

I think these are all good discussions to have like you and I are having. We can both learn from each other, as these are difficult issues. This discussion, however, is not happening out there where the decisions are being made.

 

[xrthopeful]

'hurts cosnervatives'

 

[deleted1002574]

@ROFallingDown I am answering in good faith here since it seems you are asking in good faith as well.

1) Hurts conservatives. This not neutral see article here called The Politicization of the MCAT "unfortunately, what Kirch in particular seems to want to create is a medical community that aligns as closely as possible with his particular political views—and to insist that future doctors accept those views as settled fact. " You can Google questions on the new section that are only coming from one side of the isle.

2) I agree, based on biology. Whether you are white, Asian, or black physician you should be wise on who to give AS or WBRT for. Let me quote again Dr. Jag

"Finally — and perhaps most important — diversity improves patient care. Black patients elect to receive more preventive services when they have black physicians than when they have nonblack physicians3; female patients are less likely to die after a heart attack when they are treated by female physicians than when they are treated by male physicians4; and physicians who are members of underrepresented groups are more likely than white, male physicians to serve minority, poor, and Medicaid populations.5 Promoting women and underrepresented minorities to leadership positions may well enable academic medicine to better serve our diverse population."

She is saying black patients get better care from black doctors. Females from female doctors. Please follow the logic here. Agree or disagree.

If you as a black woman see a white man for breast cancer (say umm.. Benjamin Smith) they are suggesting you would get worse care? Do you ask for a black female doctor? See official ASCO guidelines here: https://www.asco.org/sites/new-www....delines/documents/2017-diversity-strategy.pdf

This is based on RACE and GENDER. See also the oft quoted study in JCO here https://ascopubs.org/doi/full/10.1200/jco.2015.66.3658

3) We agree

4) Yes, I do. During the 2016 election NEJM asked both Trump and Clinton to write about their healthcare proposals. Only Clinton responded, but at least both candidates were given the opportunity. How is it that nearly all the other editorials are all from the liberal point of view, save for some things I saw on physician assisted suicide?

5) I agree on the legacy issue - that issue is easy. But race based is so much different. That is why I asked point blank - how many is too many Jews, Asians, and Indians? Harvard has received blowback for keeping the number Jews in the past and Asians now.

I think these are all good discussions to have like you and I are having. We can both learn from each other, as these are difficult issues. This discussion, however, is not happening out there where the decisions are being made.

Those questions stated in the article are RIDICULOUS! They say they are practice questions. If those questions are on the real test and start making up a significant component of the test in the future, then that is a problem. You said "not-neutral" and that is appreciated. Do you think this may be a heavy overcorrection of problematic questions in the past? I'm guessing it may be, but don't know for sure. I know that educators where I grew up weren't very cognizant of how to talk to people. I once got asked when I couldn't get the typewriter working if "there is an electricity where you're from" as he plugged it back in. I was 13 years old, man. Anecdote, but perhaps even in the mid 90s that shouldn't happen?

If it is proven that blacks get better care from blacks, or women get better care from women ... one answer would be to change the workforce (as I guess they are suggesting). Another answer would be to educate all of us to try to look at people as individuals and try to make better clinical decisions, or maybe a combination of these approaches.

Trump =/= conservative viewpoints. I don't really think he has the competence or interest in responding to such questions or deep-diving into policy questions, and that really hurts us all.

I don't know how too many or too few is. I don't know if I'd want only 30% of physicians to be white if we based entrance purely on scores/grades (which is probably what would happen). There is already blowback in rural communities about how Dr. Khan/Patel/Ling isn't like us, doesn't understand us (this does happen, sadly). To think that 70% of patients would be treated by people that represent 20-25% of the demographics - I'm not sure that's ideal either. In "Trump Country" (whatever that really means), it would be even more sub-optimal if they felt their needs weren't being met, if the only people in town that could afford Teslas and swimming pools don't look like them.

There is a lot to learn from each other. I think the point I was trying to make is that the dissent doesn't seem to come from a good place (in my reading of it) - I am very aware that I could be completely wrong.

 

[KHE88]

The rabbit hole they're going down basically involves looking at outcomes and trying to correlate them to provider demographics.

The question is why are they trying to do this and are these results valid and reproducible (you know what they say about doing enough subset analyses...)

No doubt, you could do a study or dig and dig and dig through data and eventually find a subset of a population that had better outcomes with old white male physicians. If it truly is about improving patient care, then we should not be afraid of that conclusion. But could you imagine a study like that getting funded or if a study produced a result that showed superior outcomes for white doctors or male doctors... could you imagine that ever seeing the light of day?

So why are we so willing to publish garbage that is trying to claim so-and-so group is better at treating so-and-so group?
It's a really really bad look. The consistent theme is shaming people for being old, white, and/or male, and the ultimate goal of all of this nonsense is to make people automatically question how a person got a position (legitimately/fairly or not) when they see an old, white, and/or male in a position of power or even being successful. And espeically one who is not apologetic for who he is.

 

[xrthopeful]

you are right, diversity and representation don't matter at all.

you are truly convincing people that you are right.

 

[deleted1002574]

I'm sincerely sorry (no sarcasm) that you you think that when a non-old/white/male (that's clunky - can I just say OWM ?) see an OWM in a position of power or even being successful, that people question how that person got that position. I generally presume that most people earned it the old fashioned way.

It seems far more often that I've heard under people's breath (or in open conversation) of how someone that is not OWM in a position of power got their position without earning it. That's not a great look either.

The rabbit hole they're going down basically involves looking at outcomes and trying to correlate them to provider demographics.

The question is why are they trying to do this and are these results valid and reproducible (you know what they say about doing enough subset analyses...)

No doubt, you could do a study or dig and dig and dig through data and eventually find a subset of a population that had better outcomes with old white male physicians. If it truly is about improving patient care, then we should not be afraid of that conclusion. But could you imagine a study like that getting funded or if a study produced a result that showed superior outcomes for white doctors or male doctors... could you imagine that ever seeing the light of day?

So why are we so willing to publish garbage that is trying to claim so-and-so group is better at treating so-and-so group?
It's a really really bad look. The consistent theme is shaming people for being old, white, and/or male, and the ultimate goal of all of this nonsense is to make people automatically question how a person got a position (legitimately/fairly or not) when they see an old, white, and/or male in a position of power or even being successful. And espeically one who is not apologetic for who he is.

 

[KHE88]

Is there something you want to contribute to the conversation from your point of view. You must be an intelligent person and I know these discourses can be frustrating, but this is one of the few places we can have a conversation on this topic. Sometimes, yes it is hostile, but would love to hear what you disagree with in a civil matter. Trolling is fine too!

A drive-by strawman argument is a lot easier than a real retort. Express a non-woke opinion? Well then you're just a Breitbart/Trumpian/Hannity/4chan/insert-outlet-to-ridcule-here idiot. Simple as that. Move along.

I'm sincerely sorry (no sarcasm) that you you think that when a non-old/white/male (that's clunky - can I just say OWM ?) see an OWM in a position of power or even being successful, that people question how that person got that position. I generally presume that most people earned it the old fashioned way.

It seems far more often that I've heard under people's breath (or in open conversation) of how someone that is not OWM in a position of power got their position without earning it. That's not a great look either.

I agree with your second statement, but to be clear I did not say that I think everyone is looking at the OWM and thinking they didn't earn it because they are OWM. What I said was that I'm worried that the end goal of all of this wokeness it to make people start to think like this. I am fully with you on wanting to believe everyone earned their position, and the only way to do that is to take race and sex out of the equation entirely. Dr. Jagsi and the Twitter crowd seem hellbent on injecting it into everything.

 

[medgator]

Several explanations have been proposed for the “leaky pipeline” of women and underrepresented minorities in academic medicine. One factor that has yet to garner attention is the lack of term limits for senior leaders, whose numbers remain disproportionately white and male.

Again, why not focus on their lack of skills etc in the 3D/conformal era etc?
I do think some posters here go a little overboard but there is a kernel of truth in all of this.

 

[RickyScott]

I guess I am getting old and out of touch because I get lost with some of the terms that are being thrown around on this thread. For the sake of clarity, I goolged the definitions

Virtue Signaling the action or practice of publicly expressing opinions or sentiments intended to demonstrate one's good character or the moral correctness of one's position on a particular issue.

Gaslighting manipulate (someone) by psychological means into questioning their own sanity.

That is all

gaslighting is from an old 1940s hollwood movie, gaslight; "virtue signalling" is an academic term bandied around by sociologists i.e. twitter posting such as: "What is the best brand of cat food to feed the ten orphan kittens I rescued this morning" purposefully lets everyone know what a fantastic human being I am.

 

[evilbooyaa]

Let's avoid posting in this thread simply to provoke those that are having a discussion about. If you have nothing of substance to add, posting something simply to piss off those having a discussion is not kosher.

 

[KHE88]

While we're at it, lets take a look at this one in the NEJM:

https://www.nejm.org/doi/full/10.1056/NEJMp1904721?query=featured_home

"Abandon requirements for making up time and for minimum numbers of cases or procedures in favor of competency assessments."

Hmmm. Ok.
I understand that having children and families is important to some people. But why should that mean you don't have to do as much training as everyone else? If you're going to allow extended time off for parental leave and allow a "competency assessment" to avoid making that time up, then you should allow the same amount of time off to those who don't take parental leave with the option of a "competency assessment" as well.

I was personally very annoyed by those who felt for some reason entitled to have to undergo less training because they had children during residency. Sorry. Either our training is important or its not. Same rules for everybody no special treatment. But I'll just get called a woman-hater for having that opinion, so I keep my mouth shut.

 

[medgator]

While we're at it, lets take a look at this one in the NEJM:

https://www.nejm.org/doi/full/10.1056/NEJMp1904721?query=featured_home

"Abandon requirements for making up time and for minimum numbers of cases or procedures in favor of competency assessments."

Same reason I feel Holman is BS, personally

 

[deleted1002574]

Sigh. No you won't be called a woman hater. Do you see why people may get the impression that the vociferous ones are acting like the victims?

In fact, I agree with you. I agree that women should get that time and undergo a competency assessment. I agree that if a man wants to do that, they can, too. I think both parents should be involved in raising small children and paternity leave is a sign of a modern society.

The PROBLEM ... please ... THE PROBLEM is not the man who doesn't get the time off and competency assessment (which again, as above, I AGREE should be an option). The PROBLEM is that maternity leave has not been traditionally offered, that there isn't a good idea of what to do when people do take 3 months off except for asking them to tack 3 more months on. If we can design an equitable way to measure competency/skills AND allow for people - and let me be clear again - BOTH MEN AND WOMEN (AND WHATEVER OTHER GENDER IS TAKING CARE OF CHILDREN) - should have that option.

It's the right thing to do. Goodness. I'm usually used to being the snowflake, @KHE88, you are not a woman hater. I promise I don't think so. You brought up a good point. And I believe you do love women.

While we're at it, lets take a look at this one in the NEJM:

https://www.nejm.org/doi/full/10.1056/NEJMp1904721?query=featured_home

"Abandon requirements for making up time and for minimum numbers of cases or procedures in favor of competency assessments."

Hmmm. Ok.
I understand that having children and families is important to some people. But why should that mean you don't have to do as much training as everyone else? If you're going to allow extended time off for parental leave and allow a "competency assessment" to avoid making that time up, then you should allow the same amount of time off to those who don't take parental leave with the option of a "competency assessment" as well.

I was personally very annoyed by those who felt for some reason entitled to have to undergo less training because they had children during residency. Sorry. Either our training is important or its not. Same rules for everybody no special treatment. But I'll just get called a woman-hater for having that opinion, so I keep my mouth shut.

 

[taserlaser]

Canada’s residencies are transitioning to competency based medical education instead of time based models as we traditionally know, for some of these reasons discussed. This year‘s cohort is the first year radiation oncology will be on a competency based model. Most residents are anticipated to graduate in 5 years, but allow for shorter or longer residencies on a personalized basis. The goals are not time spent in clinic or case numbers, but rather demonstrated competence in ’radiation oncologist’ specific roles.

 

[deleted1002574]

As an aside: I see a lot of these viewpoints from the Joe Rogan/Jordan Peterson/Quillette.com/Ben Shapiro/IDW world. As someone who clearly identifies as a pretty "down the line" liberal, age and curiosity has led me to break out of my bubble, try to read mostly only things I disagree with, and try to have understanding about those who disagree (and agree) with me. I think the IDW movement has come up with some great ideas, destroyed a lot of stupid mainstream ideas, and have created a really exciting/interesting "intellectual third space". At the same time, the very bubble that they have helped in bursting has led to a creation of a new bubble in their own world.

And it's this idea of thinking they know what someone is going to say in response to them. I.e. "if I say this, then I will be called a woman hater, so I'm only going to discuss it in my world with people that agree with me" or "if I say that then I'll be thought of as racist". But, it's trying to predict what others think, trying to put people into a box, trying to pigeon hole someone based on one characteristic - that's the very thing the IDW was initially created to stop. I was impressed with the creative and verbally agile way that they analytically and intellectually dismantled the old guard "intellectual elite". But, in such a short time, they are turning into what they sought to destroy.

If we ask the questions why women are being introduced by first names and their achievements minimized, that doesn't mean I'm calling OWM racist. If we are trying to figure out an appropriate way to handle maternity/paternity leave and you disagree with a component of it, doesn't mean I will call you sexist. If you are trying to figure out why people want a third bathroom, you're not whatever-ist. I also wonder these same things (maybe instead of introducing a third bathroom or letting people "identify" which bathroom to go to, um, maybe we can just have unisex ones with doors/stalls?) If we are figuring out how to figure out why certain groups have worse outcomes, there are going to be some studies that may show things that we are clearly uncomfortable with. Let's be intellectually honest in the debate, instead of thinking people are our opponents before they even engage.

One more idea re: the childbearing and residency thing. Keep the requirements and allow some amount of flex time at significantly reduced pay (maybe no pay?) FOR EVERYONE. If you are going to need 6-18 months for whatever reason, fine. Use that flex time for maternity or paternity or to travel to Appalachia to help in an addiction clinic. Poke some holes in this, say it costs too much, but don't close your mind and say I'm a -ist, or that I think you're an -ist because you disagree.

 

[RadOncDoc21]

The other question that follows from this is if rural areas need more radiation oncologists and most of the people in those areas are white... shouldn't they actively recruit more white people? Maybe it's a bad look to say "Hey we want white people, but only for the rural areas."

Lose / Lose situation here...

last thing we need is more white people!

 

[FrostyHammer]

A couple of things

1) I can't wait until Reshma Jagsi has to point out actual real life people, not imaginary "white men" to bring down. She needs to WALK THE WALK in her own dept. before trying to clean up the rest of the world. FIRE YOUR OWN WHITE MALE CHAIR WHO HAS BEEN THERE A LONG TIME. Oh btw, see some other random who cares b/c they are white males under Theodore Lawrence as well on their website


View attachment 283571

2) Dr. Jagsi keeps harping about URMs - UNDER represented minorities. SHE IS ASIAN/INDIAN = OVER REPRESENTED minority. Be consistent and apply your own rules to YOURSELF. Bonus How long have you kept your deputy chair position? Isn't time for you to move over for a true URM.

Mind you there are only 2-3% Jews in the population and 6-7% Asians, but I believe these groups make up 10-15% and 20-25%, respectively. Dr. Jagsi tell us how much is too much? Perhaps you can just ask your alma mater / Harvard for advice.

3) I have been saying here for a while, this is eventually going to spill over into the patient doctor relationship. I am not looking forward to the day when patient's ask for a white, black, Asian, Hispanic, Muslim, Jewish, etc. doctor that best matches their own identity. Following on the heals of this will be those who will want to ask on ideological basis. Politics is destroying everything why should the patient-doctor relationship be spared?

She's very famous for always playing the victim card. She's done it as long as I can remember.

 

[Lamount]

Not sure this will convince anyone of anything... just tells some what they want to hear, and others what they want to hate. Everyone wins!

 

[DCballa]

Overall message is meant to be beneficial. Some of these posts are just unbelievable. It is a good thing to increase the number of minorities in the field (especially since they can offer different perspectives to problems). It is a good thing to do term limits especially if recruitment will lead to more influx of money into departments as well as fresh ideas. Too many people on high horses here.

 

[KHE88]

Overall message is meant to be beneficial. Some of these posts are just unbelievable. It is a good thing to increase the number of minorities in the field (especially since they can offer different perspectives to problems). It is a good thing to do term limits especially if recruitment will lead to more influx of money into departments as well as fresh ideas. Too many people on high horses here.

What's unbelievable is the inability to think critically about this topic without focusing on skin color and genitalia.
The problem is that statements like this suggest that if you disagree or present logical criticism, then you are racist and/or sexist. For instance, I absolutely do not have a problem with "minorities" (presumably you are referring to ethnic minorities) in the field, which your post unfairly suggests. Suggesting that hiring be entirely merit-based and blind to color and sex is NOT the same thing as believing that having a measurable increase in the number of minorities or women in the field is a bad thing. This is an obvious logical fallacy. If you can prove that there currently exists an inequality of opportunity in this field, then I am all for removing whatever artificial barriers have been constructed to limit opportunities for advancement. However, simply pointing out numbers (such as x number of y skin color, z number of females, a vs. b average income, etc) does not prove anything in regards to whether in inequality of opportunity exists. It is a not-so-clever trick to conflate equality of opportunity with equality of outcome. They are not the same, nor should they be. Only one of those things should be guaranteed.

So why is it that forcing diversity specifically in skin color and genitalia is the only thing we should focus on if we are trying to increase "money (wtf) as well as fresh ideas"? Why not things like height, physical disability, age, family financial status, education, place of birth, physical attractiveness, intelligence, or any other number of things that people have historically been discriminated on? Why focus on just these two? When you look at it critically, it is amazing how quickly this house of cards falls down, and it is a travesty that so many resources are spent on "diversity research" to the point that we have so-called academics creating entire careers with C.V.s built entirely of these publications polluting the NEJM with this nonsense screaming victim victim victim in everybody's face enough to the point where we have to accept it as fact lest the Twitter outrage mob call you a sexist and try to ruin your career.

To the poster who said what's wrong with things like diversity and inclusion deans? Again, how many resources are devoted to this unneeded administrative bloat? What are the salary of all these administrators? Why does healthcare cost so much?

To the poster who basically said it's wrong that I think I can't have opinions like this because I assume everyone will be out to get me. Well, I think most people are reasonable and can look at things logically. But the problem is a vocal minority, specifically the kinds of people who use twitter and forums like ROhub for the purposes of virtue signaling and self-promotion, will absolutely attack you for any sort of disagreement. Remember what happened to that guy who posted some honestly mild criticism and a differing viewpoint regarding all this perceived victimization on ROhub?

 

[radoncgrad2019]

Anyone who pulls the ‘if color of skin matters why aren’t we talking about height and weight etc for diversity’ is a complete joke

 

[medgator]

Anyone who pulls the ‘if color of skin matters why aren’t we talking about height and weight etc for diversity’ is a complete joke

Agree, but skill and competence should be right up there as an argument as well. Far more compelling reason to get rid of some of these academic dinosaurs

 

[Neuronix]

It's easy to tick a box that says someone is a different gender or ethnicity in order to show diversity.

I grew up poor with a schizophrenic mother who was in and out of the mental hospital. I bounced around lower class family members growing up. I went to a poor inner city high school and was always a minority growing up in my community. I have a GED, moved out when I was 16, and I was homeless for awhile in my late teens. I bummed around for a couple years before back dooring my way into my public state school. I'm a white guy, and so nobody ever knows the difference. Most people never want to hear about any of this. I have always had the stats to compete with everyone else, so I just go on trying to be a physician-scientist.

From my position, the discussion about increasing diversity through ethnicity and gender is just diversity by ticking boxes. I agree diversity of thought is important. But if thought is only about skin color, then what have we become as a society? That an african-american, latino, asian, etc have diverse thoughts just based on their ethnicity is a form of racism in itself to me. But the groupthink has become so common now that to even have a difference of opinion is like an attack. To go against the narrative of minorities means diversity is a microaggression that reflects bad on whoever speaks about it. So I don't usually say anything. I feel totally unable to discuss this with anyone in real life, despite being in an interracial marriage with mixed race children.

You could say that it's privilege that I blend in with the majority in medicine. But is it really? Nobody gave me extra money for education, and nobody has ever given me extra consideration for admission, promotion, grants, etc for my skin color. I've always just stepped up and brought the stats to compete on merit. Even when that meant working full-time in college, living in a $200 studio shoebox through college, and competing as a top pre-med with absolutely no pre-med prep whatsoever.

When I interview people now, I want to know--what are your ideas? What have you overcome? If you're a minority from a middle class or better background with the same message as everyone else, why should there be extra consideration? But this is too complicated. Tick a box, person is a minority, shows diversity. Improves stats. That's how the USA works nowadays in academics, and I don't want to be labelled as anti-diversity, so I will go back to my anonymous corner.