- "There were no openings in Dermatology."
- "I can stay underground in the department all day and I don't have to
come out until dark."
- "The voices told me to do it."
- "It was the only residency I could get this year that would let me stay
in New York City."
- "You mean we don't read x-rays? What kind of a radiology residency is this?"
Recently, things have changed
significantly as our specialty has come to be seen as highly desirable.
While this could be construed as a form of mass
hysteria, the fact is that the only way to get a Radiation Oncology
residency now is to inherit one. No, that's probably an exaggeration. As
long as an applicant had a stellar record in medical school, excellent recommendations
from appropriate faculty members, and a PhD, there still is a chance to
get a residency.
After all, having a strong research background is important in all fields
of medicine, especially if an ongoing project might result in the ASTRO
Resident Research Award and, ideally, the Nobel
prize. Eventually it could turn out that absolutely no one has good enough
credentials to be accepted, resulting in depopulation of our specialty,
and, mercifully, extinction.
Before this happens, there might be one last chance to interrupt this trend.
Obviously, the current system needs to be changed. Right now there's a "match"
system in place which institutionalizes the procedure of having people officially
assigned to the places that have already made an agreement with them. It's
like going through a lot of rituals to have an arranged marriage between
two people who have already been living together for five years and have
two kids. It's time to make the process truly competitive and not to discourage
physicians with fewer than two lead articles in "Science" from trying to
get into our field.
It won't do any good to have exquisite treatment plans and meticulous outcome data
and literature reviews when you're being evicted from your own department or when you're
allowed to stay on at a salary that's less than the department administrator gets
(not that there's anything wrong with that, if any of them are reading this).
We need at least 4 years of being restocked with people aggressive enough to
deal with referring physicians, hospital CEOs, managed care despots, and the government,
not just super scientists who will get run over by every special interest group in existence.
The plan is that for the next 4 years the specialty can be revitalized using a new selection process.
This would be similar to the mating habits of the Uganda
kob, which has guaranteed survival of these fine creatures over thousands
of years. The only prerequisite would be to have a medical degree, one PGY-1
year, and the desire and ability to absorb and give out punishment.
I can't reveal the specifics, but sign up is in Tora Bora at 0500 hours on
CMS and ASCO, get ready to rumble.