Cardiology (interventional) or ENT???

[drivesmecraazee]

I wouldn't be surprised to be the only student trying to decide between these two, but actually, I don't find these THAT different, sure... one's a surgical speciality and the other is medical. But still, both have a nice mix of clinic and procedures.
Now let me tell you a little bit about myself so you can understand why Im trying to decide between these two... I liked IM, I liked clinic and I like the intelectual stimulation and the broad knowledge that IM requires... but I feel the need to do stuff or I start to get very bored, this is why I really liked cardiology, I know that it's not the most cerebral speciality in IM but I still get to think and do some stuff.
Then I rotated in ENT during my surgery rotation and found the surgeries waaay more fun than cardiology procedures, the clinic is interesting too and I found otolaryngologists a little bit more cerebral than other surgeons, Im not that much of a nerd but I still like to think and some other surgeons seemed to be like plain "doers".

Anyone else who went for ENT got that feeling? Like you needed to both think and do stuff? If so... Did the speciality filled your expectations?

Excuse me if my english isn't that good, I don't live in the States

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[resxn]

Those 2 are so vastly different, I think you may be the only person deciding between them. I would say this, intervention cardiology (at least right now) makes a ton more money--in the US anyway. BUT if you found that the ENT procedures are more interesting in just a month, think about how you'll feel after doing either one for 10 years. If you're less stimulated in 4 weeks, you'll be miserable in 10 years.

Also, you will be more than intellectually challenged in ENT. That's not something you need to worry about.

 

[drivesmecraazee]

Those 2 are so vastly different, I think you may be the only person deciding between them. I would say this, intervention cardiology (at least right now) makes a ton more money--in the US anyway. BUT if you found that the ENT procedures are more interesting in just a month, think about how you'll feel after doing either one for 10 years. If you're less stimulated in 4 weeks, you'll be miserable in 10 years.

Also, you will be more than intellectually challenged in ENT. That's not something you need to worry about.

I really don't want you to think Im being paranoid or something like that. But this clearly seems like an insult to me... Why would I specifically be more intelectually challenged??
Given the hostility I've felt in this forums I wouldn't be surprised if you did actually insult me. I don't know why, but it seems like many people here don't like me, maybe it's just a cultural difference, Im hispanic and I really like americans, you're very polite but I often get the feeling that you're a little bit more cold and distant in the way you express yourselves, hispanics are way more expressive and maybe that bothers you, I really don't know. Maybe it's not a cultural difference, maybe it's just me, well, I never said anything to make everyone angry on purpose.
So if Im wrong excuse me... And if you really meant to insult me then do it directly, I won't start arguing with you, I'll just stop posting. You actually seem like a really cool guy, you treat everyone around here with respect so I don't know what did I do to piss you off (if you are actually pissed off)

 

[asmallchild]

I really don't want you to think Im being paranoid or something like that. But this clearly seems like an insult to me... Why would I specifically be more intelectually challenged??
Given the hostility I've felt in this forums I wouldn't be surprised if you did actually insult me. I don't know why, but it seems like many people here don't like me, maybe it's just a cultural difference, Im hispanic and I really like americans, you're very polite but I often get the feeling that you're a little bit more cold and distant in the way you express yourselves, hispanics are way more expressive and maybe that bothers you, I really don't know. Maybe it's not a cultural difference, maybe it's just me, well, I never said anything to make everyone angry on purpose.
So if Im wrong excuse me... And if you really meant to insult me then do it directly, I won't start arguing with you, I'll just stop posting. You actually seem like a really cool guy, you treat everyone around here with respect so I don't know what did I do to piss you off (if you are actually pissed off)

Wow, overreact much? I don't see a lot of hostility in resxn's post. Yours, on the other hand.....

 

[drivesmecraazee]

Wow, overreact much? I don't see a lot of hostility in resxn's post. Yours, on the other hand.....

I was prepared for this, I knew everyone would post stuff like this. I DID felt some hostility in his post, but hey... let him say what he wants to say, if he says to me he didn't meant to insult me I will surely offer him a sincere apology.

 

[lord_jeebus]

I really don't want you to think Im being paranoid or something like that. But this clearly seems like an insult to me... Why would I specifically be more intelectually challenged??
Given the hostility I've felt in this forums I wouldn't be surprised if you did actually insult me. I don't know why, but it seems like many people here don't like me, maybe it's just a cultural difference, Im hispanic and I really like americans, you're very polite but I often get the feeling that you're a little bit more cold and distant in the way you express yourselves, hispanics are way more expressive and maybe that bothers you, I really don't know. Maybe it's not a cultural difference, maybe it's just me, well, I never said anything to make everyone angry on purpose.
So if Im wrong excuse me... And if you really meant to insult me then do it directly, I won't start arguing with you, I'll just stop posting. You actually seem like a really cool guy, you treat everyone around here with respect so I don't know what did I do to piss you off (if you are actually pissed off)

I agree that you are overreacting to a personal pronoun. If anything I would read it in a reassuring way.

 

[DrJD]

I really don't want you to think Im being paranoid or something like that. But this clearly seems like an insult to me... Why would I specifically be more intelectually challenged??
Given the hostility I've felt in this forums I wouldn't be surprised if you did actually insult me. I don't know why, but it seems like many people here don't like me, maybe it's just a cultural difference, Im hispanic and I really like americans, you're very polite but I often get the feeling that you're a little bit more cold and distant in the way you express yourselves, hispanics are way more expressive and maybe that bothers you, I really don't know. Maybe it's not a cultural difference, maybe it's just me, well, I never said anything to make everyone angry on purpose.
So if Im wrong excuse me... And if you really meant to insult me then do it directly, I won't start arguing with you, I'll just stop posting. You actually seem like a really cool guy, you treat everyone around here with respect so I don't know what did I do to piss you off (if you are actually pissed off)

He was merely responding to YOUR concerns about ENT not being intellectually stimulating.

Often times in english, one uses the word "you" rather than "one." He was merely saying, don't worry ENT is intellectually stimulating. But since he was specifically reassuring you, he told you that you would be intellectually challenged. Trust me, it was not an attack on you.

Don't just assume that because you are mexican people are out to get you. Secondly, there are some rude people on SDN, but they are few and far between on the Oto boards. Good luck with your future endeavors!

 

[smq123]

Well, the OP is actually Costa Rican, not Mexican, but anyway....

drivesmecraazee - no need to worry. He was not insulting you. Best of luck to you!!

 

[DrJD]

Well, the OP is actually Costa Rican, not Mexican, but anyway....

drivesmecraazee - no need to worry. He was not insulting you. Best of luck to you!!

My bad, all I saw was him referring to himself as "hispanic" and I instantly associated that with Mexico... (I know it refers to other countries as well but statistically here in the US, Mexico was my best guess, ha)

 

[drivesmecraazee]

He was merely responding to YOUR concerns about ENT not being intellectually stimulating.

Often times in english, one uses the word "you" rather than "one." He was merely saying, don't worry ENT is intellectually stimulating. But since he was specifically reassuring you, he told you that you would be intellectually challenged. Trust me, it was not an attack on you.

Don't just assume that because you are mexican people are out to get you. Secondly, there are some rude people on SDN, but they are few and far between on the Oto boards. Good luck with your future endeavors!

You're right, in english people uses the word "you" rather than "one".
Im very sorry. Excuse me please. I never meant to start a fight, I just tought he was insulting me and wanted to know the reason. Actually, I was very surprised because, just like you said, everyone in the Oto boards are cool, and of course resxn is one of them.
A lot of hispanics often feel persecuted and discriminated all the time, believe me, Im not of those, it's just that I've heard of a few bad experiences. Im sure you're all educated and tolerant people.
Thanks.

 

[cool c]

you are not the only one deciding between these two. I went through a similar decision last year. I ended up choosing cards over ENT. A decision I am regretting at this particular point in time. Just remember, you could match into ENT and if don't like it, very easily switch to medicine. Switching from medicine to ENT is just impossible. I would keep that in mind. Either way, no decision you make will be terrible as long as you've thought about it. Having said this, you will probably always wonder what could've been. My advice would be to pick a specialty and forget about the other one.

 

[drivesmecraazee]

Hey!! Glad to know there's at least someone who has been in my position.
Why are you regretting your decision?

 

[forbin]

I actually wanted to do cardiology when starting medical school. I think cards and ENT are superficially similar, but really fairly different. How many procedures do cardiologists actually do? I'm admittedly not an expert, but I can think of caths, pacemakers, and TEEs. I'd personally get bored only doing 5 or so procedures for the rest of my career. Ultimately ENT is a surgical field with a lot of medical management. Cardiology is ultimately a medical field with some procedures.

 

[drivesmecraazee]

I actually wanted to do cardiology when starting medical school. I think cards and ENT are superficially similar, but really fairly different. How many procedures do cardiologists actually do? I'm admittedly not an expert, but I can think of caths, pacemakers, and TEEs. I'd personally get bored only doing 5 or so procedures for the rest of my career. Ultimately ENT is a surgical field with a lot of medical management. Cardiology is ultimately a medical field with some procedures.

TRUE!!

But how "medical" is the medical management in ENT?? How much diferential diagnosis one must do in ENT??? This questions got me thinking

 

[resxn]

I really don't want you to think Im being paranoid or something like that. But this clearly seems like an insult to me... Why would I specifically be more intelectually challenged??
Given the hostility I've felt in this forums I wouldn't be surprised if you did actually insult me. I don't know why, but it seems like many people here don't like me, maybe it's just a cultural difference, Im hispanic and I really like americans, you're very polite but I often get the feeling that you're a little bit more cold and distant in the way you express yourselves, hispanics are way more expressive and maybe that bothers you, I really don't know. Maybe it's not a cultural difference, maybe it's just me, well, I never said anything to make everyone angry on purpose.
So if Im wrong excuse me... And if you really meant to insult me then do it directly, I won't start arguing with you, I'll just stop posting. You actually seem like a really cool guy, you treat everyone around here with respect so I don't know what did I do to piss you off (if you are actually pissed off)

yes. By saying "you", I meant "anyone" would be more than intellectually stimulated by ENT. I am and I'm a friggin' genius. Just kidding. But I do think ENT provides far less formulaic calculation and diagnosis than does cardiology, especially interventional cardiology. Find the blockage, name it, stent it. Seems pretty routine to me. Closest subspecialty in ENT to that I think is otology--people come in with 1 or more of 5 complaints (hearing loss, tinnitus, pain, discharge, dizziness) and the dx and tx is fairly formulaic. Not that it's not interesting, but it's more formulaic than is head and neck cancer or even rhinology in my opinion. Others are more than welcome to disagree.

 

[resxn]

TRUE!!

But how "medical" is the medical management in ENT?? How much diferential diagnosis one must do in ENT??? This questions got me thinking

the medical management is becoming far more lucrative in ENT in the United States in an era of decreasing procedural reimbursement. In any specialty follow the money and that is where you will see the most innovation and the most progress. The same is true in otolaryngology. Minute to minute you will see a significant reimbursement advantage for things done in the clinic versus things done in the OR. I think most otolaryngologists will admit that they would prefer being in the OR, but can make more money in the clinic.

the differential diagnosis in otolaryngology can be surprisingly vast even for simple things. For example, this morning I saw a patient with pain and occasional numbness in the left side of his tongue. The differential diagnosis for this condition is huge and the potential workup is long if the H&P isn't too helpful. It could be as simple as burning tongue syndrome, but with numbness and paresthesias, nerve conditions from neoplastic to neuralgias need to be considered. Auto-immune conditions are possible as are infectious processes. I consider this intellectually challenging despite the fact that in all likelihood it is not life-threatening.

 

[drivesmecraazee]

Thanks resxn!!!!

 

[cool c]

My reason for regret have actually been mentioned in the forum. Fact is I like procedures and working with my hands more than medical management and clinic. I am realizing in the end cardiology has 4-5 procedures which got boring after a couple weeks of working in the cath lab. ENT being a surgical field has much more variety and hence more interesting cases to my liking. Not to mention, it takes about 6-7 years just to get to a point where u do procedures in cardiology. It's too late for me, I suggest you save yourself and make a wise and a right decision that's best for you.

 

[neutropeniaboy]

the differential diagnosis in otolaryngology can be surprisingly vast even for simple things. For example, this morning I saw a patient with pain and occasional numbness in the left side of his tongue. The differential diagnosis for this condition is huge and the potential workup is long if the H&P isn't too helpful. It could be as simple as burning tongue syndrome, but with numbness and paresthesias, nerve conditions from neoplastic to neuralgias need to be considered. Auto-immune conditions are possible as are infectious processes. I consider this intellectually challenging despite the fact that in all likelihood it is not life-threatening.

If he has burning tongue, you should just cut it out. That will stop the burning. (At least that's how I do it.)

 

[resxn]

Not a bad idea. I'll offer that.

Turns out he had a hypoglossal schwannoma. How crazy is that. Resection is not a bad idea at all now.