Radiation Oncology

Radiation Oncology Residency Questions

What advice would you give about getting letters of recommendation in your specialty?

If you are serious about pursuing radiation oncology as a career then, do as many rotations in the specialty as possible which will help you get good LORs.

What is the value of doing audition rotations in your specialty?

Treatment of cancer involves multidisciplinary teamwork. Oncologists, including radiation oncologists, are integral to this team. Radiation oncologists specialize in treatment of cancers with x-rays. Radiation therapy, the use of x-rays for therapy, crosses the path of cancer DNA at some point in the journey of cancer treatment of most patients, from cure to palliation. Other than learning about the field specifically, doing radiation oncology rotation will help you learn general oncologic principles and will also help you in getting LORs in case you wish to pursue this career thereafter. Like radiation therapy, this rotation will not go waste if you decide not to pursue radiation oncology after shadowing or rotating. Because you can use the knowledge gained in this rotation in other oncologic sub-specialties (e.g., medical or surgical oncology, urology, palliative care etc.)

To what extent does research, publications, or presentations affect one’s ability to match in your specialty?

Research, publications, presentations go a long way in making you a very competitive applicant for the field. Although not mandatory, most students applying for radiation oncology tend to spend a good amount of time in research (clinical and or bench) or have a PhD, MBA or MPH to boost their application. Academic programs tend to seek applicants with strong research background.

Is a Step 2CK score needed before you will invite someone for an interview?

Not necessarily. Most programs don’t need Step 2 CK but some do. I would recommend you check with each program individually for their specific requirements.

What does the perfect applicant look like in your specialty?

High Step 1 score, No fails in any steps, excellent medical school credentials, research (preferably publications or at-least abstracts in national radiation oncology meetings), good/excellent LORs preferably from radiation oncologists from department where and with whom you rotated. Be on top of your game when it comes to notes, literature. Having a PhD, MBA, or MpH is a bonus.

Does having a below average Step 1 score doom you in your specialty?

Generally speaking, you are unlikely to be shortlisted for a radiation oncology residency interview with below average Step 1 score. However, in extremely rare instance, if you have everything else stellar on your application, then that may discount the step 1 score.

Would you ever take someone with a Step 2CS failure?

No

Does a student need to Honor in your specialty in order to match?

Not necessarily.

The students have significant elective time during their 2nd and 3rd year for career exploration.

Is there anything else I haven’t asked that you feel an applicant to your specialty ought to know?

Radiation Oncology was considered a secret. It no longer is. In fact, it is one of the most, if not the most, competitive residencies to get into. Many outside think we are technicians/button pushers and most people think we sit in front of a computer all day. Radiation oncology is probably one of the, if not the most evidence based specialties in medicine. It is a field that requires:

1. Constant life-long reading/learning (given the rapidly evolving biological understanding of the disease, rapid changes in technology and treatment delivery methods). It requires the treating physician to keep up with the most up-to-date knowledge of management paradigms, and evidence based literature to deliver safe and most effective treatment. It is a field that emphasizes lengthy patient interaction, sometimes requiring difficult conversations, as well as collaboration with other specialties (particularly medical oncology, surgical oncology, pathology, palliative care), and a team of nurses, therapists, dosimetrists and physicists. Unlike most other fields radiation oncology allows ample opportunities to perfectly blend: a) clinical knowledge (eg anatomy, biology, radiology, pathology, patient data including history/physical exam/symptoms/signs,
2. Surgical skills required for brachytherapy,
3. Non-clinical skills (eg radiation physics, computational skills), and when necessary d) research skills (contributing/conducting research trials or prospective/retrospective analysis) to come up with the most optimal and effective treatment plan which can include external beam radiation and/or brachytherapy that finally results in achieving the bigger goal of helping cancer patients.