Sauna

Quite the opposite actually! The advances in med onc such as immunotherapy, targeted therapy, and hormonal therapy are driving patients back to rad onc. There are many cancer sites (ie breast, prostate) that are becoming more of a chronic disease and as these patients live longer they develop more mets (bone, liver, brain, etc.) that are resistant to systemic treatment and require radiotherapy or SBRT. Every specialty in cancer care has its limitations and that's why we work together to provide patients with the best outcomes. You'll find very few cancers that are treated with systemic therapy alone, and those are mainly liquid. This is because chemo/systemic therapy won't help you much if a solid tumour remodels it's extracellular matrix and blocks off all the drug with walls of collagen/glycoproteins, or if the cancer creates an endless maze of vasculature surrounding and within the tumour that all the drug diffuses out before reaching all of its targets, or if the cancer metastasizes to the brain and your drug can't cross the BBB, etc. you get the point. You need local treatment at some point whether that's surgery or radiation (or both). As for the competitiveness of Rad Onc in CaRMs, it's a mix of poor job market + popularity. Not many med students (let alone residents/attendings) know much about the speciality, and out of those who discover it, some are turned away by the job market. The job market problem has been (and is being) addressed and actually looks very promising. We've kept the number of residency spots the same for the past decade to avoid over-saturating the job market, and the most recent data from CARO 2021 actually looks pretty good. Almost everyone has gotten a job and it's projected to continue improving for at least the next 5 years and even reach a point where demand > supply. There is talk of actually increasing residency spots again to prepare for this.

I was on the same boat as you in med school. Here is some of the cool Rad Onc tech that got me excited about the field. Cool video showcasing modern rad onc treatments: Cyberknife: Gamma Knife: MRI-Linac: SABR Brachytherapy

I matched to Rad Onc this cycle! Many programs shared their alumni lists with us while interviewing, and most recent graduates were able to find employment (staff or locum) after 1 fellowship. There were also outliers who found employment straight away or who did 2 fellowships. Overall, it looks like things are slowly improving! I think it was less popular this year, at least partially, because people didn’t get enough exposure through visiting electives. Anecdotally I can think of a few people in my class who were considering it but weren't able to secure a home school elective. It's also a smaller specialty, so small fluctuations (ie 5 less people applying) could have a big impact on the match. Overall, It’s a very rewarding specialty and such a hidden gem in medicine that not a lot of people get exposure to or know about. If you enjoy: - emotionally satisfying patient encounters and relationships from treating cancer or relieving painful end of life symptoms (including long-term continuity of care in the form of post-treatment surveillance) - cutting edge technology - probably the most advanced technology used in modern medicine (See this, this, or this) - procedural work (radiation treatment planning, brachytherapy) - creativity and creating personalized treatment plans based on anatomy and clinical/patient factors - Multi-disciplinary, teamwork-based so you get to make lots of friends from other specialities and allied health professions - Lots of exciting advances to look forward to in the future such as cardiac radiosurgery, treating oligo-metastatic disease with SABR, FLASH, and radio-pharmaceuticals I can go on all day but I honestly think when it comes to the day-to-day work of rad onc, no other specialty comes close to how sweet this career is! The downsides are the geographic limitations - it's a resource-heavy specialty so you need to be at a hospital/cancer centre (can't just set up in a plaza somewhere and practice RO). I think it's an amazing option if you're looking to match in the 2nd round- both Ottawa and Queen's were pretty high up on my rank list actually. Hit me up if you have any questions

90 hours

I think they’re just reminding the other students that not everyone matches so it’s important to be compassionate when interacting with the 4th years about this topic. I can only imagine how much it sucks to go unmatched, but it would be much worse if on top of that I have to answer to a bunch of people messaging me about what I matched to.

oh hi

If there are extenuating circumstances or if it’s just one block, you will have a chance to write a supplementary exam. If you pass the supplementary exam, you get the same P on your transcript that everyone else has. If it’s more than one block, there will be a more in-depth discussion about what is going on and whether it’s better to write 2+ supplementary exams or repeat the year. This is very rare.

It’s both; frequent low stakes assessments + feedback, as well as a final exam that you need to pass to pass the block. Passing grade is a 60.

Go celebrate!!

Yes, Queen’s has had the highest match rate in the country consistently. If you look at the specialties people are matching to, it’s usually been around ~1/3 primary care, ~1/3 internal medicine, and ~1/3 surgery/other. We did very well again this year (2020) from what I’ve heard, with grads matching to the most competitive specialties and locations. I think that a strong applicant can match to their specialty of choice from any school, but Queen’s does a great job of providing support and direction. For example, my class is currently scheduled for 1 on 1 meetings with our career advising faculty to discuss how covid-19 will impact our individual career choices, and to provide support/answer any questions.

Good questions! It’s unique to Queen’s because of the ratios. Let’s look at 2 examples. Example 1: You are scheduled for a psyc outpatient clinic. You arrive and the attending tells you to start seeing patients and review with them after each encounter. You end up seeing 10 patients. Example 2: You are scheduled for a psyc outpatient clinic. You arrive and there’s a R1 there as well. The attending tells you both to start seeing patients and review with them after each encounter. You end up seeing 5 patients and the resident sees the other 5. Multiply this across all 2 years of clerkship and that’s the difference having additional learners creates. Having just one additional learner can make the difference between scrubbing in to assist with a surgery and there being no room for you at the table because residents and fellows are prioritized. @bumbleb33 provided an excellent response to this. I will just add that this hasn’t been a problem for me during pre-clerkship.

Congrats! Both solid programs, you can’t go wrong. There’s way more than 3 pro’s but imo the top 3 are: 1. Community. Yes, I know everyone says they have an amazing and friendly community. This is probably true, but QMed is just on a whole other level. For example, check this out. Or this. Find me another school that does this stuff and you can have the rest of my LOC. More info on the community in case you missed it. Another unique part of our community is that we’re the only Ontario school with 1 campus and 1 stream, so you’re whole class will be in the same room every day (for pre-clerkship). 2. Small learner:faculty ratio. I knew about this when I chose Queen’s but didn’t fully appreciate it until I started clerkship. This is probably my favourite part of clerkship. The QMed formula for success goes like this: The most important factor when it comes to matching is elective/clinical performance —> The best way to improve your clinical performance is with practice and seeing lots of patients to apply what you learned in pre-clerkship—> a learning environment with a low learner:faculty ratio, like Queen’s, provides this. This is one of the reasons Queen’s has the top match rate in the country. Essentially it means that you’ll be maximizing the amount of time spent managing your own patients. On internal medicine for example, you’re responsible for managing, assessing, and coming up with a plan for 5-6 patients that you round on in the morning and review with your team at lunch. You’ll be catching a ton of babies on OBSGYN. There are tons of opportunities for you to do procedures that would normally be done by residents. We are very strong clinically because of this, in fact two of my classmates saved a guy’s life at a Loblaws a few months ago. 3. With 3 post-secondary schools in a town of ~120k, Kingston is a big education hub. This has many implications; the faculty are here because they love teaching (when they accepted their job offers they knew that teaching would be a big component of what they do), there are lots of student-oriented activities, lots of cool coffee shops for studying, a beautiful pier, the highest number of restaurants per capita in Canada. This is a unique way to spend your 4 years of med school that probably can’t be replicated again in your lifetime. The main con for me was also Kingston. Kingston is a small town so there’s less stuff to do, but tbh there’s not much to do in London either, compared to bigger cities like Toronto and Ottawa. We still go to Toronto every couple of weeks anyway for Raptors games etc. There are a lot of older houses, but you don’t necessarily have to live there. There’s no cool downtown luxury condos, but at least you’re saving money (which is probably what you want to do at this stage of your training). There’s definitely more cons than this but I can’t recall them tbh either because I’ve found solutions or have learned to live with them. There’s definitely no deal breaker cons unless you want to be close to family/friends who are not in Kingston. Hope this helps

Namaste

Happy to answer any questions

There’s only 60 cases in Kingston compared to other cities which have way more, so I think that probably played a role in this.