Should a formal radiology year(s) be added to the radiation oncology residency training program given the number and increasing modalities used for target delineation and treatment planning?

As I close in on the end of my career, I must disagree with this idea! I’m sure we all are greatly impressed by the clinical acumen of our fourth-year medical students but that is not enough clinical training. My three-year medical residency taught me how to be a DOCTOR, my radiation oncology residency taught me how to be a radiation oncologist. We are clinicians first, contourers and image interpreters second. Don’t complain when other specialists and primary care practitioners think of us as ancillary care providers. We can’t have it both ways!

Not at the moment. Residency programs are required to provide a month of it (ACMGE reqs) or fill that requirement with tumor boards where cases are presented with a radiologist present. Adding time to the residency would either have to squish out clinical rad onc training, which is a bad trade-off, or add a year to the training. There's a funny push inside academic medicine to consider adding time to residencies due to the duty hour reductions in experience (not a factor in rad onc), but funding for training is not going to increase for medical education. Long story short: Best specialty ever will still be 5 years. :)

I very much see your point, however. Imaging and knowing tumor vs normal variant is becoming increasingly important as we co...

Intern year should be converted to a radiology year. I don’t think being a ‘hospitalist for a year’ is useful for us, but being a ‘diagnostic radiologist for a year’ would be by improving our contouring ability and that translates directly to better outcomes. Dedicated time to learn from hundreds of cases in multiple reading rooms and side by side with a radiologist or senior resident would be valuable over the status quo of self study and tumor board attendance. I came across this question in the list of search results and think the topic should be considered again, but realistically, it will never change and the time I took to type this answer is also lost, ugh.