RadOnc

I took the first two days of this month's Radiation Oncology research rotation to nail the Surgery shelf test. They only told me that I passed, but I'm sure that I did much better this time. No stupid questions trying to redefine anatomy on this version of AZCOM's homemade tests.

I also spent a lot of time catching up with classmates while suffering through on campus didactics. I sure didn't miss the boring lectures during the last four months. However, it was great to hear how everyone is doing, what they are planning on going into, rotation experiences, etc.

Then I was pleasantly surprised to learn that my Preceptor this month is letting me see interesting patients and get in on the cool procedures. I even got to see how a dosimetry plan is generated by the physists for external beam treatment of breast cancer. The best part so far though was helping to insert brachytherapy catheters into guys' perineums and womens' breasts. We then deposited (temporarily or permanently) radioactive sources like Iodine131 into specific catheters at specific locations in the lesions. They actually had most of the surgical "cool" factor to them, but no suturing or Bovey aroma. On the most recent no urologist was present, so I did their job of placing all the catheters.

Most of my time though is spent reading through patient records and filling out research surveys for each one. We are trying to publish the largest post-prostatectomy external beam radiation therapy study to date. So it's a lot of paperwork, but I have the opportunity to get my name on a published study. The office is the largest private RadOnc group in the country and they enter more patients into studies than any RadOnc group in the country, including Universities! So I think they know what they are doing.

This Friday I'm going the St. Joe's office to see their Gamma and Cyber Knife systems. That will be awesome, and it will allow me a chance to ask the Attending what is happening with the paper I submitted to him a few months ago for publishing. I had a minor contribution with a classmate, but any published papers look good.

After almost two weeks doing RadOnc and learning that one of our fourth year students matched RadOnc at Drexel, I think it is much more doable. It would mean 60+ applications, hopefully 5-10 interviews and then a move to who knows where. But the Docs in my office feel I have a shot at RadOnc and should go for it.

At this point, I'm trying to decide whether to try for both RadOnc and EM in the Match or just EM. Going after both means more applications, more expensive interviews and probably listing a couple RadOnc programs as my first and second choices then seeing what happens next March. If I stick with EM, I might be able to get an early contract at a DO program and skip all the time, expense and stress of the Match. The Arrowhead, CA program I'm going to rotate at in August may just work into that plan. However, the income, technology and patient contact of RadOnc is very attractive. I'm tempted to try for RadOnc to see what happens with EM as my backup.

I just finished a bike ride with my attending this morning. We started at his brand new 3800sf house in North Scottdale. What a place! According to Zillow.com, nothing in his zip code goes for less than a million, even the lots start at $500k. And he's less than two years out of residency! He laid out how his contract works with two years guaranteed income then full partner. It's a pretty good gig, and the Docs all say that likely changes to medical reimbursement shouldn't have a huge negative impact on RadOnc. I have a hard time believing there won't be some decreases when procedures can easily run from $100k to $200k, but even a 10% decrease in reimbursements would leave RadOncs as some of the best paid Docs in medicine.

My thinking at the moment is to audition at Arrowhead in August, hopefully Maricopa ER in September and a RadOnc program in October (one that has 2+ slots for non MD/PHDs, if such a thing exists). I may need to double book November with both a RadOnc and an EM program, doing the RadOnc rotation if it's still in the running.

I hate to make things so complicated, but I'm not ready to up on a shot at RadOnc yet either. Two more weeks to go on this rotation along with a lot of studying for the Family shelf test. There's always a chance, however slight, that things will become clearer.