Letter to Medical Students

[MegaVoltagePhoton]

How were other specialties able to limit expansion? This anti-trust thing is either bull, or a red herring.

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[medgator]

How were other specialties able to limit expansion? This anti-trust thing is either bull, or a red herring.

Their academic leadership understood the bigger picture and simply didn't expand to the same degree. Derm and urology are good examples.

No one on is going to take an anti trust case against a specialty for not expanding enough to meet demand

 

[fiji128]

The anti trust thing is non sense. Just an easy thing to say as if MDs have any idea about anti trust law and how it might be applied to residency expansion.

One way programs could be limited is increase the requirements for a training program to be accredited. The RRC requirements could be raised to 4 linacs and 10 attendings on site. Many programs would not be able to meet this standard.

 

[medgator]

The anti trust thing is non sense. Just an easy thing to say as if MDs have any idea about anti trust law and how it might be applied to residency expansion.

One way programs could be limited is increase the requirements for a training program to be accredited. The RRC requirements could be raised to 4 linacs and 10 attendings on site. Many programs would not be able to meet this standard.

That would be a more arbitrary requirement than simply upping the minimum required number of brachy and srs/sbrt cases at a given program which would accomplish the same thing but would pass muster imo.

At my program we did plenty of ldr prostate, also Hdr sarcoma, gyn and occasional breast and h&n. Also met peds requirements in house.

If we just held programs accountable to being full spectrum practices, many of these questionable new programs would likely have to close down.

 

[RickyScott]

The anti trust thing is non sense. Just an easy thing to say as if MDs have any idea about anti trust law and how it might be applied to residency expansion.

An antitrust challenge could be mounted, but the standard in these type of actions is public good, when I asked a antirust lawyer (partner in big law)

 

[medgator]

An antitrust challenge could be mounted, but the standard in these type of actions is public good, when I asked a antirust lawyer (partner in big law)

Public good would be to not waste resources training too many ROs

 

[RickyScott]

Public good would be to not waste resources training too many ROs

exactly especially since government heavily subsidizes training and medical school, and docs may have been better used in another specialty. Also, too many docs has been shown to lead to overutilization

 

[barsoum.michael]

I'm really interested in rad onc what is the best way to enter this field? I've been really interested in immunotherapy. I'm currently in my first year. As a rad onc we don't have any exposure or involvement with immunotherapies?

 

[medgator]

I've been really interested in immunotherapy.

Then go into med onc/heme onc

 

[RickyScott]

I'm really interested in rad onc what is the best way to enter this field? I've been really interested in immunotherapy. I'm currently in my first year. As a rad onc we don't have any exposure or involvement with immunotherapies?

I bet you want a job as well that is not in north dakota.

 

[scarbrtj]

I'm really interested in rad onc what is the best way to enter this field? I've been really interested in immunotherapy. I'm currently in my first year. As a rad onc we don't have any exposure or involvement with immunotherapies?

As a rad onc, you will have a fraction of the knowledge about immunotx vs med oncs. The size of that fraction is debatable, never greater than 1, and you will never directly administer immunotx, tx patients for immunotx side effects, monitor pt response to immunotx, etc. But as a rad onc you can co-PI w/ a med onc to run an XRT+immunotx trial, perhaps have a lab where you study immunotx+XRT (rare for rad oncs overall). But as far as "involvement"/"exposure": you will read about immunotx in journals/textbooks, be tested about immunotx on board exams, see patients on immunotx as RX'd by other MDs, perhaps refer pts to other MDs for immunotx... that's 'bout it. Immunotx drug reps never buy a rad onc lunch, put it that way.

 

[medgator]

Immunotx drug reps never buy a rad onc lunch, put it that way.

The imfinzi/AZ rep did when the PACIFIC trial data came out, and when it got FDA approval in stage III NSCLC getting definitive chemo/XRT

Sometimes the med oncs need reminding... I've convinced them to give it a few times when we do salvage chemo xrt for unresectable mediastinal node recurrences after prior lobectomy/wedge resection.

 

[ganglia777]

As a rad onc, you will have a fraction of the knowledge about immunotx vs med oncs. The size of that fraction is debatable, never greater than 1, and you will never directly administer immunotx, tx patients for immunotx side effects, monitor pt response to immunotx, etc. But as a rad onc you can co-PI w/ a med onc to run an XRT+immunotx trial, perhaps have a lab where you study immunotx+XRT (rare for rad oncs overall). But as far as "involvement"/"exposure": you will read about immunotx in journals/textbooks, be tested about immunotx on board exams, see patients on immunotx as RX'd by other MDs, perhaps refer pts to other MDs for immunotx... that's 'bout it. Immunotx drug reps never buy a rad onc lunch, put it that way.

this explains why people are advising med students to go into heme/onc instead of rad onc. Heme/onc will eat rad onc's lunch by 2025. It's reasonable to predict that salaries for heme/onc will be higher than rad onc within the next decade.

 

[medgator]

this explains why people are advising med students to go into heme/onc instead of rad onc. Heme/onc will eat rad onc's lunch by 2025. It's reasonable to predict that salaries for heme/onc will be higher than rad onc within the next decade.

Already happening in some places.

Big heme onc practices with good wholesale pricing on iv drugs, in house dispensing/pharmacy etc, and even in house rads and path to really juice the revenue