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Radiation oncologists entering academic medical practice should strive to have all crucial representations reduced to enforceable promises in a contract which they review with a healthcare attorney licensed in the jurisdiction where the medical practice is located. Surveys of employment benefits should be consulted. Specific contract provisions are discussed to maximize physician flexibility and security.

Ethical issues arise when a professional endeavor such as medicine, which seeks to place the well-being of others over the self-interest of the practitioner, meets granular business and legal decisions involved in making a livelihood out of a professional calling. The use of restrictive covenants, involvement in self-referral patterns, and maintaining appropriate comity among physicians while engaged in the marketplace are common challenges in radiation oncology practice. A paradigm of analysis is presented to help navigate these management challenges.

The Practice Entry Survey presentation is a highly anticipated session for the radiation oncology (RO) resident at the American Society for Radiation Oncology annual meeting. Each year the senior author reports the employment outcomes and job market experiences for the most recently graduated RO residents.The Practice Entry Survey has been continuously administered annually to graduated RO residents since 1984 via the Association of Residents in Radiation Oncology directory. Six years of individual-level data, from 2012 to 2017, were readily available for analysis. The questionnaire queries the workforce placement experience and collects debt, salary, and benefits information. Respondents were subgrouped by practice type (academic vs private practice), and results were tested for trends over time.Survey data were collected from 302 recently graduated residents. There were 7 in fellowship and 1 practicing internationally, leaving 294 eligible for analysis. They identified themselves as working in either an academic setting (n = 150 [51%]) or private practice (n = 144 [49%]). First-year salaries for those in private practice were more than those in academics ($303,000; [interquartile range, $270,000-$375,000] versus $280,000 [interquartile range, $260,000-$325,000]; P.01). With regard to the job search, 21.8% of respondents found their jobs through the online American Society for Radiation Oncology Career Center, while most respondents, 77.2%, found their jobs through other means. Respondents also ranked the items they found to be most helpful during the interview process.These data can help gauge the competitiveness of an offer as well as what to expect during the job hunt and interview process.

In this era of globalization and rapid advances in radiation oncology worldwide, the American Society for Radiation Oncology (ASTRO) is committed to help decrease profound regional disparities through the work of the International Education Subcommittee (IES). The IES has expanded its base, reach, and activities to foster educational advances through a variety of educational methods with broad scope, in addition to committing to the advancement of radiation oncology care for cancer patients around the world, through close collaboration with our sister radiation oncology societies and other educational, governmental, and organizational groups.

In 1992 the Association of Residents in Radiation Oncology (ARRO) conducted its ninth annual survey of all residents in training. The survey identified perceived strengths and shortcomings of training. Factors influencing the choice of Radiation Oncology as a medical specialty were identified. Residents raised concerns over the adequacy and preparation of training. Factors influencing the decision to enter private practice or academic medicine were also identified. Future surveys are planned to expand this important database.

1. 1. Both capacity and resistance adaptations were evident. 2. 2. Body size and starvation affected the capacity adaptation to temperature. 3. 3. Most of the differences in patterns of temperature acclimation of crayfish reported in the literature can be attributed to the degree to which the animals were starved. 4. 4. Temperature-insensitive zones in the M:T curves occurred only in starved crayfish. 5. 5. Time, temperature, feeding level, and their interactions, significantly affected water and lipid concentrations of whole animals. 6. 6. Lack of feeding rather than an internal nutrient level seemingly caused the reduced V2 of starved crayfish.

A retrospective review of 248 patients with squamous cell carcinoma of the supraglottic larynx was undertaken to determine the relationship between the probability of control of the primary lesion, the extent of neck nodal disease at initial presentation, and its ultimate control. All patients were treated at the U.T. M. D. Anderson Hospital between 1960 and 1980, and had a minimum of 3 years follow-up. The primary lesion was staged T1 in 38 patients, T2 in 132, T3 in 50 and T4 in 28. The initial volume of neck nodal disease was scored on a scale of 0 (no palpable nodes) to 9 (bilateral neck nodes greater than 6 cm in diameter). All primary lesions were treated definitively with megavoltage radiation therapy. Treatment to the neck varied according to the extent of lymph node involvement. There was no significant difference in the range of total radiation doses delivered to the primary lesion, stage for stage, in patients who presented with clinically negative or positive nodes, or in those with controlled versus uncontrolled neck disease. Analysis of the probability of primary tumor control was made by life table methods because of the poorer survival expectation in node positive patients. For T1 and T2 primary lesions, any positive node decreased the probability of primary tumor control (p = 0.06). For T3 and T4 lesions, a single node less than 3 cm in diameter did not worsen the chance of primary tumor control, but any greater degree of lymph node involvement did (p = 0.03). For both T stage groupings, the probability of primary tumor control at 5 years decreased progressively with increasing neck nodal disease. Primary tumor control probability was also significantly associated with control of the neck disease, independent of the modality of neck treatment. No correlation could be demonstrated between the histological grade of the primary tumor and initial lymph node status or tumor control probability. Possible interpretations of this manifestation of biological heterogeneity are discussed.