Hello applicants. I am a fourth year student who just matched into radiation oncology, and i could not be happier with the place i ended up. I used this forum heavily during the application process because I don't have a home program and there is no one at my school who is familiar with how to apply to rad onc. This forum is a blessing (thanks to Gfunk) and a curse (thanks to many of the other posters here). One can easily get discouraged from applying based upon the supposed "stats" of other applicants.
Radiation Oncology is a very competitive field... anyone who tells you otherwise is trying to sell you something. That being said, you don't have to walk on water to match. I will share with you what I have learned during my (thankfully) limited exposure to the application process. Check out the FAQ for a more eloquent description.
Logically, you should consider the application process to have two phases: pre-interview and interview.
Pre-interview, there are four general considerations in your application (in no particular order)
1) Preclinical/clinical grades (i.e. are you Junior or Senior AOA? in the top of your class?). In 2011 roughly 1/3 of rad onc matches were AOA, and 96% of AOA rad onc applicants matched.
2) Boards scores (generally speaking Step1 is much more important than Step 2) Average on Step 1 is somewhere in the 240s
3) Research (cue the dramatic music). It seems like rad onc specific research definitely helps. I personally didn't have any rad onc research, but I had several other publications (some physics manuscripts from undergrad and non-onc presentations in med school). My sense is that my lack of rad onc research prevented me from getting interviews at SOME top places. It is possible that some top programs use this as a means of screening applicants prior to interviews, but not everyone does this... so don't think that you are hopeless if you don't have 3 first authors pubs in the red journal. If you have ANYTHING in rad onc, it certainly helps a lot, so try your best to get in on a project early (circumstances permitting). Having an MD/PhD certainly helps... but it isn't a requirement (I don't have one), and I get the sense that it was less important in this current application year than it was in previous years. As Gfunk said in his FAQ, it is very hard to crack into this field without ANY research at all. Research is important in radiation oncology, and residencies want to make certain that you are capable of publishing.
4) LORS and connections. This also seems to be a fairly important part of the application. Since I didn't have a home residency (just a clinical rad onc department), I did two away electives and got LORs from both. I again had the sense that my lack of big-wig connections hurt me, but it clearly wasn't a deal breaker. That being said, if you have the opportunity to impress a well known radiation oncologist and get a letter from them, you would be crazy not to take advantage of that opportunity.
You don't have to be the best in all four categories to get interviews (the top programs are obviously more stingy with interviews because... well... they can be). Some programs value grades/boards scores more, other value research/LORs more... and every possible permutation. I get some interviews from upper tier programs, and got snubbed by some mid tier programs... there didn't seem to be much of a rhyme or reason to it. If you don't excel in any of the four categories, applying may be an uphill battle for you.
If you want to improve your chances of getting interviews, consider which of the four areas you are deficient in. If you dont have great grades or board scores, a great research pub and a phone call/LOR from your influential PI could help offset your. If you are struggling in all four areas but still really want to enter the field, consider taking a planned year off and apply to do rad onc research at a well known center with a well known radiation oncologist.
Once you DO get an interview, the playing field becomes a little bit more equal between you and your fellow applicants. I got the sense that the interview was more important in rad onc than it is in other fields... probably because there are so few applicants accepted to a given program (2-5 compared to 30+ for int med), so the faculty have more of a stake in making certain that they can work well with every resident. By yourself, and don't be afraid to show how excited you are about the field. Interviewers really want to believe that you are truly interested in radiation oncology, so hone your personal narrative concerning how you first were introduced to the field, and when you "fell in love" with it (i.e. don't say "I did really well on the boards, so people told me to apply for rad onc"). Research comes up during interviews, so make certain you can describe ALL of the research on you application clearly and concisely. If you don't have any radiation oncology specific research, consider some rad onc research that you are interested in doing in the future (i.e. during residency) and why this research interests you. Additionally, it wouldn't be a terrible idea to do a quick search before an interview to see what rad onc research that particular program is currently working on.
After the interview, send a thank you note (at bare minimum) to the program director and department chair.
If you wanna cover your bases, send an individualized thank you note to everyone you interviewed with (this can obviously be pretty tedious, but you just spent $1000 flying across the country so writing a few emails won't kill you). If you plan on doing this, make certain to write a word or two after each meeting on your interview day so that you can keep all of the discussions straight. Some programs make you talk to over 12 people! It is impossible to remember who said what for you individualized thank you notes unless you write down a quick word as you are leaving the room. I used the UCSF rubric, and I sent all of my thank you notes via email. I found email easier (obviously), and it also has the added benefit of opening a line of communication with the faculty. I have had some long exchanges with faculty following me emailing them a thank you note, and I think this helped make me stand out.
Good luck!
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How about a good ol' fashioned "what are my chances" thread?
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